Organization
BAYLIFE PHARMACY INC
Active
Other names
BAY LIFE PHARMACY I
Organization subpart
No
Provider details
NPI number
Authorized official
JULIAN MATHEW (OWNER)
(727) 254-2037
Entity
Organization
Contact information
Practice address
1235 S MISSOURI AVE, CLEARWATER, FL 33756-9111
(727) 581-5400
(727) 581-5411
Mailing address
1235 S MISSOURI AVE, CLEARWATER, FL 33756-9111
(727) 581-5400
(727) 581-5411
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
PH22395
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004617900
—
FL
Enumeration date
08/17/2017
Last updated
07/21/2022
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