Healthcare Provider Details

I. General information

NPI: 1790864460
Provider Name (Legal Business Name): BAYER PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

219 MAIN ST
SMITHVILLE TX
78957-1839
US

IV. Provider business mailing address

219 MAIN ST
SMITHVILLE TX
78957-1839
US

V. Phone/Fax

Practice location:
  • Phone: 512-237-2211
  • Fax: 512-237-3202
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number05672
License Number StateTX

VIII. Authorized Official

Name: GARY BAYER
Title or Position: PRES
Credential: RPH
Phone: 512-237-2211