Organization
BAYSIDE RX LLC
Active
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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