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General NPI Number Information
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NPI Number | 1407872658
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Entity Type | Organization
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Legal Business Name | BAYSHORE PHARMACY INC
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 01/05/2022
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Provider Practice Location Address
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Address Line | 3315 BURKE RD STE 201
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City | PASADENA
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State | TX
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Zip | 77504-1823
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Country | US
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Telephone | 713-944-8893
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Fax | 713-944-8890
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Provider Business Mailing Address
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Address Line | 3315 BURKE RD STE 201
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City | PASADENA
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State | TX
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Zip | 77504-1823
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Country | US
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Telephone | 832-606-2583
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Fax | 713-944-8890
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALI HAIJA
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Credential | RPH
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Telephone | 832-606-2583
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 24424
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License Number State | TX
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