# BAY AREA MEDICAL CENTER INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** BAY AREA OUTPATIENT PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811004872
- **Authorized official:** WILLIAM F TACCOLINI (PHARMACY DIRECTOR)
- **Authorized official phone:** (715) 735-6621

## Contact information

- **Practice address:** 3100 SHORE DR-, SUITE COS, MARINETTE, WI 54143-4242
- **Practice address phone:** (715) 735-8072
- **Practice address fax:** (715) 735-8011
- **Mailing address:** 3100 SHORE DR-, SUITE COS, MARINETTE, WI 54143-4242
- **Mailing address phone:** (715) 735-8072
- **Mailing address fax:** (715) 735-8011

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 8044-042 | WI | Yes |

## Other

- **Enumeration date:** 08/24/2006
- **Last updated:** 04/08/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 33058800 | — | WI |