Provider Demographics
NPI:1245800374
Name:BAYSIDE PHARMACY LIMITED PARTNERSHIP
Entity Type:Organization
Organization Name:BAYSIDE PHARMACY LIMITED PARTNERSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HIMAL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-566-0116
Mailing Address - Street 1:300 STATE ST STE 102
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16507-1428
Mailing Address - Country:US
Mailing Address - Phone:814-351-0026
Mailing Address - Fax:
Practice Address - Street 1:300 STATE ST STE 102
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16507-1428
Practice Address - Country:US
Practice Address - Phone:814-351-0026
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-30
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336I0012XSuppliersPharmacyInstitutional Pharmacy
No282N00000XHospitalsGeneral Acute Care Hospital