# BAY TOWN PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Favre's Baytown Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093189599
- **Authorized official:** KARIE BOYD (PHARMACY OPERATIONS MAMANGER)
- **Authorized official phone:** (601) 630-6730

## Contact information

- **Practice address:** 620 BLUE MEADOW RD, BAY SAINT LOUIS, MS 39520-2834
- **Practice address phone:** (601) 326-5378
- **Mailing address:** 610 BLUE MEADOW RD SUITE 10A, BAY SAINT LOUIS, MS 39520
- **Mailing address phone:** (601) 326-5378

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 11/20/2015
- **Last updated:** 02/01/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2156132 | PK | — |