Provider Demographics
NPI:1932720356
Name:BAYPHARM HEALTH SYSTEMS
Entity Type:Organization
Organization Name:BAYPHARM HEALTH SYSTEMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:DALEY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:727-238-7672
Mailing Address - Street 1:1147 SE GRAHAM CT
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32025-2841
Mailing Address - Country:US
Mailing Address - Phone:727-238-7672
Mailing Address - Fax:
Practice Address - Street 1:1147 SE GRAHAM CT
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32025-2841
Practice Address - Country:US
Practice Address - Phone:727-238-7672
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-27
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy