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Organization

BAYSIDE PHARMACY LIMITED PARTNERSHIP

Active
Other names
Bayside Pharmacy and Physician Supply
Organization subpart
No

Provider details

NPI number
Authorized official
HIMAL SHAH (AUTHORIZED OFFICIAL/OWNER)
(231) 580-1601
Entity
Organization

Contact information

Practice address
300 STATE ST, SUITE 102, ERIE, PA 16507
(814) 351-0026
(814) 351-0027
Mailing address
300 STATE ST, SUITE 102, ERIE, PA 16507
(814) 351-0026
(814) 351-0027

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
PP411870L
PA
3336C0003X
Community/Retail Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
103854880-0001
PA
01
3954547
NAT'L ASSN BOARD PHARM
PA
Enumeration date
07/08/2005
Last updated
05/06/2025
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