Organization
BAY STREET PHARMACY INC
Active
Other names
BAY STREET PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA TOLLE (PRES)
(772) 589-2043
Entity
Organization
Contact information
Practice address
7746 BAY ST, SEBASTIAN, FL 32958-3427
(772) 589-2043
(772) 388-2628
Mailing address
PO BOX 368, ROSELAND, FL 32957-0368
(772) 589-2043
(772) 388-2628
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
PH8549
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105269100
—
FL
05
—
105269103
—
FL
01
—
2163656
PK
—
Enumeration date
08/19/2016
Last updated
08/19/2016
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