Active NPI
Bayside Pharmacy LLC
Doing business as Butterfly Pharmacy
- Community/Retail Pharmacy
- Winter Haven, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- PH31592
- Legal business name
- BAYSIDE PHARMACY LLC
- Doing business as
- Butterfly Pharmacy
- Practice address
- 205 1St St S Ste 106
Winter Haven, FL 33880-3266 - Phone
- (863) 377-4774
- Fax
- (863) 377-4744
- NPI assigned
- Aug 24, 2018
- Last updated
- Mar 12, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Prof. Chiranjivi B Jannu, R.PH
- Title
- Director of Pharmacy
- Phone
- (646) 673-0044
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | PH31592 | FL | Primary |
| Long Term Care Pharmacy | 3336L0003X |
Addresses
Primary practice location
205 1St St S Ste 106
Winter Haven, FL 33880-3266
Mailing address
205 1St St S Ste 106
Winter Haven, FL 33880-3266
Phone (863) 377-4774
Other names 1
- BUTTERFLY PHARMACY
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20201202002063 | FL | Part B Supplier - Mass Immunization (Roster Biller Only) | 7416368030 | Practice locations: Zephyrhills, FL |
National Provider Directory
National Provider Directory- Tax ID family
- Bayside Pharmacy
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
Locations
205 1st St S
Ste 106
Winter Haven, FL 33880
Phone (863) 377-4774
35772 State Road 54
Zephyrhills, FL 33541
Phone (954) 399-5700
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Ownership & related parties
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Pharmacist
- Tampa, FL
- NPI 1831219336
-
- Pharmacist
- Tampa, FL
- NPI 1275933897
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535068800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1741737600000",
"number": "1023599321",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 1ST ST S STE 106",
"city": "WINTER HAVEN",
"state": "FL",
"postal_code": "338803266",
"telephone_number": "863-377-4774"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 1ST ST S STE 106",
"city": "WINTER HAVEN",
"state": "FL",
"postal_code": "338803266",
"telephone_number": "863-377-4774",
"fax_number": "863-377-4744"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BAYSIDE PHARMACY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-08-24",
"last_updated": "2025-03-12",
"certification_date": "2025-03-12",
"status": "A",
"authorized_official_last_name": "JANNU",
"authorized_official_first_name": "CHIRANJIVI",
"authorized_official_middle_name": "B",
"authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
"authorized_official_telephone_number": "646-673-0044",
"authorized_official_name_prefix": "Prof.",
"authorized_official_credential": "R.PH"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "FL",
"license": "PH31592",
"primary": true
},
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "BUTTERFLY PHARMACY",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Winter Haven, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.