Provider Demographics
NPI:1992000830
Name:BAY DRUG, LLC
Entity Type:Organization
Organization Name:BAY DRUG, LLC
Other - Org Name:BAY DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GAETANO
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:FORTE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:206-353-1425
Mailing Address - Street 1:25379 WAYNE MILLS PL # 300
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-1827
Mailing Address - Country:US
Mailing Address - Phone:661-294-9411
Mailing Address - Fax:661-294-9452
Practice Address - Street 1:281 TURK ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-3807
Practice Address - Country:US
Practice Address - Phone:415-400-5999
Practice Address - Fax:415-400-5998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-25
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy