Organization
BAYSIDE LAKES PHARMACY LLC
Active
Organization
BAYSIDE LAKES PHARMACY LLC
Active
Other names
Bayside Lakes Family Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN ELIZABETH MACDONALD (OWNER)
(321) 308-0303
Entity
Organization
Contact information
Practice address
1850 ELDRON BLVD SE STE 7, PALM BAY, FL 32909-6870
(321) 308-0303
(321) 308-0310
Mailing address
1850 ELDRON BLVD SE, PALM BAY, FL 32909-6870
(321) 308-0303
(321) 308-0310
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PH31554
FL
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100868600
—
FL
01
—
PH31554
BOARD OF PHARMACY
FL
Enumeration date
07/25/2018
Last updated
12/21/2018
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up