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Organization

BAYSIDE RX LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MISS JACLYN PRISCO N/A (PRESIDENT)
(347) 749-8544
Entity
Organization

Contact information

Practice address
21411 41ST AVE, BAYSIDE, NY 11361-2133
(347) 749-8544
(718) 522-2388
Mailing address
21411 41ST AVE, BAYSIDE, NY 11361-2133
(347) 749-8544
(718) 522-2388

Taxonomy

Speciality
Code
Description
License number
State
3336M0003X
Managed Care Organization Pharmacy
Primary
NY

Other

Enumeration date
04/12/2016
Last updated
04/12/2016
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