Healthcare Provider Details

I. General information

NPI: 1811215189
Provider Name (Legal Business Name): JAMES JOSEPH BAYZICK RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2010
Last Update Date: 05/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 E BROAD ST
BRIDGETON NJ
08302-2831
US

IV. Provider business mailing address

310 BEEBE RUN RD
BRIDGETON NJ
08302-5679
US

V. Phone/Fax

Practice location:
  • Phone: 856-455-0777
  • Fax:
Mailing address:
  • Phone: 856-453-1584
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI01962900
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP034606L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: