Organization
BAYRX LLC
Active
Other names
MIKE'S PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA GOLUNOVA CPHT (OWNER / VP)
(510) 532-1002
Entity
Organization
Contact information
Practice address
2700 INTERNATIONAL BLVD STE A, OAKLAND, CA 94601-1555
(510) 532-1002
(515) 532-1011
Mailing address
2700 INTERNATIONAL BLVD STE A, OAKLAND, CA 94601-1555
(510) 532-1002
(515) 532-1011
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHY50028
CA
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5636519
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
12/01/2009
Last updated
01/19/2010
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