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General NPI Number Information
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NPI Number | 1942666532
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Entity Type | Organization
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Legal Business Name | BAYVIEW COMMUNITY PHARMACY LLC
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Dates
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Enumeration Date | 01/12/2016
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Last Update Date | 02/05/2016
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Provider Practice Location Address
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Address Line | 1846 E LITTLE CREEK RD
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City | NORFOLK
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State | VA
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Zip | 23518-4204
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Country | US
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Telephone | 757-383-6636
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Fax |
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Provider Business Mailing Address
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Address Line | 1846 E LITTLE CREEK RD
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City | NORFOLK
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State | VA
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Zip | 23518-4204
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Country | US
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Telephone | 757-383-6636
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | LAURA KELLEY
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Credential |
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Telephone | 757-390-5287
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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 | 0201004681
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License Number State | VA
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