Provider Demographics
NPI:1336140961
Name:BYFIELD DRUG INC.
Entity Type:Organization
Organization Name:BYFIELD DRUG INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:GAYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-854-6532
Mailing Address - Street 1:6272 LEE VISTA BLVD
Mailing Address - Street 2:LEGAL DEPT
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-5148
Mailing Address - Country:US
Mailing Address - Phone:888-773-7376
Mailing Address - Fax:888-773-7386
Practice Address - Street 1:12 KENT WAY
Practice Address - Street 2:SUITE 120E
Practice Address - City:BYFIELD
Practice Address - State:MA
Practice Address - Zip Code:01922-1221
Practice Address - Country:US
Practice Address - Phone:888-419-9993
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-04
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3436-224219333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200024930AMedicaid
NH30702768Medicaid
SC7M3199Medicaid
IN200441900AMedicaid
MD404526200Medicaid
KY54006176Medicaid
MTMONTANAMedicaid
NJ0017574Medicaid
MA404594Medicaid
AKPH518MAMedicaid
ID80667200Medicaid
AZ851106Medicaid
NM86175050Medicaid
ME408530000Medicaid
PA1008747260001Medicaid
KS200256070AMedicaid
CT3117191Medicaid
IA566349Medicaid
MA404594Medicaid
PA1008747260001Medicaid