Healthcare Provider Details

I. General information

NPI: 1942365366
Provider Name (Legal Business Name): BAYVILLE PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 09/19/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

253 BAYVILLE AVE
BAYVILLE NY
11709-1670
US

IV. Provider business mailing address

253 BAYVILLE AVE
BAYVILLE NY
11709-1670
US

V. Phone/Fax

Practice location:
  • Phone: 516-628-3640
  • Fax: 516-628-3657
Mailing address:
  • Phone: 516-628-3640
  • Fax: 516-628-3657

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number018083
License Number StateNY

VIII. Authorized Official

Name: WILLIAM TRAMPEL
Title or Position: PRESIDENT
Credential:
Phone: 516-628-3640