MEDICARE: BAY HEALTH PHARMACY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1548814759
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAY HEALTH PHARMACY INC

Provider Business Mailing Address
First Line	:	6415 BAY PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-3969
Country	:	US
Telephone Number	:	718-234-6500
Fax Number	:	718-234-6503

Provider Business Practice Location Address
First Line	:	6415 BAY PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-3969
Country	:	US
Telephone Number	:	718-234-6500
Fax Number	:	718-234-6503

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ELIZABETH NICOLE MAKH
Credential	:
Telephone Number	:	718-234-6500

Provider Enumeration Date	:	07/25/2019
Last Update Date	:	07/25/2019

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