MEDICARE: BAY RX 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	:	1891518767
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAY RX PHARMACY INC

Provider Business Mailing Address
First Line	:	1160 BAY ST
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10305-4933
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1160 BAY ST
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10305-4933
Country	:	US
Telephone Number	:	718-535-3800
Fax Number	:

Authorized Official
Title or Position	:	SP
Name	:	MR. AHMED ELNAGDY
Credential	:	PHARMD
Telephone Number	:	718-535-3800

Provider Enumeration Date	:	11/07/2024
Last Update Date	:	11/07/2024

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