Provider Demographics
NPI:1588851968
Name:BAYVIEW PLAZA PHARMACY INC
Entity Type:Organization
Organization Name:BAYVIEW PLAZA PHARMACY INC
Other - Org Name:BAYVIEW PLAZA PHARMACY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:STREDLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-435-6846
Mailing Address - Street 1:7930 CHESAPEAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23518-3846
Mailing Address - Country:US
Mailing Address - Phone:757-605-3382
Mailing Address - Fax:757-605-3386
Practice Address - Street 1:7930 CHESAPEAKE BLVD
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23518-3846
Practice Address - Country:US
Practice Address - Phone:757-605-3382
Practice Address - Fax:757-605-3386
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-28
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
VA02010041733336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
4840458OtherNCPDP PROVIDER IDENTIFICATION NUMBER