| NPI | 1548268022 |
|---|---|
| Doing Business As | BAYSIDE PHARMACY AND PHYSICIAN SUPPLY |
| Entity Type | Organization |
| Authorized Contact | HIMAL SHAH Authorized Official/Owner 231-580-1601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy (Licence: PA PP411870L) |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2025-05-06 |