Provider Demographics
NPI:1073111951
Name:PHARMACY ON BAY STREET INC.
Entity Type:Organization
Organization Name:PHARMACY ON BAY STREET INC.
Other - Org Name:PHARMACY ON BAY STREET INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPERVISING PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:MENATALLA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAAD
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:929-269-7000
Mailing Address - Street 1:1209 BAY ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-3121
Mailing Address - Country:US
Mailing Address - Phone:929-269-7000
Mailing Address - Fax:
Practice Address - Street 1:1209 BAY ST
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-3121
Practice Address - Country:US
Practice Address - Phone:347-967-9186
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-13
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy