Organization
BAY PHARMACIES INC
Active
Other names
BAY PHARMACY HEALTH MART
Organization subpart
No
Provider details
NPI number
Authorized official
TANAPONG CHAIRIN RPH (SEC/TREAS)
(920) 746-2977
Entity
Organization
Contact information
Practice address
1300 EGG HARBOR RD, STURGEON BAY, WI 54235-1277
(920) 746-2977
(920) 746-2968
Mailing address
1300 EGG HARBOR RD, STURGEON BAY, WI 54235-1277
(920) 746-2977
(920) 746-2968
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
6547-042
WI
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2114324
PK
—
05
—
33127300
—
WI
Enumeration date
02/08/2007
Last updated
06/23/2014
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