Healthcare Provider Details

I. General information

NPI: 1205979721
Provider Name (Legal Business Name): BAYARD L C PHARMACY CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113-33A 41ST AVE
FLUSHING NY
11355
US

IV. Provider business mailing address

113-33A 41ST AVE
FLUSHING NY
11355
US

V. Phone/Fax

Practice location:
  • Phone: 212-219-8116
  • Fax: 212-219-8115
Mailing address:
  • Phone: 212-219-8116
  • Fax: 212-219-8115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: TIAN XIA CHEN
Title or Position: PRESIDENT
Credential:
Phone: 212-219-8116