NPIMap

Organization Active NPI

Bay Street Pharmacy Inc

  • Long Term Care Pharmacy
  • Sebastian, FL
National Provider Identifier
1528513595
Registry record updated Aug 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
PH8549 Issued in FL
Legal business name
BAY STREET PHARMACY INC
Doing business as
Bay Street Pharmacy Inc
Practice address
7746 Bay St
Sebastian, FL 32958-3427
Phone
(772) 589-2043
Fax
(772) 388-2628
NPI assigned
Aug 19, 2016
Last updated
Aug 19, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Theresa TolleNPI 1376548859
Title
Pres
Phone
(772) 589-2043

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)CodeLicenseStatePrimary
Pharmacy 333600000X
Long Term Care Pharmacy 3336L0003X PH8549 FL Primary

Addresses

Primary practice location

7746 Bay St
Sebastian, FL 32958-3427

Mailing address

PO Box 368
Roseland, FL 32957-0368
Phone (772) 589-2043

Other identifiers 3

IdentifierTypeStateIssuer
105269100MedicaidFL
2163656OtherPK
105269103MedicaidFL

Other names 1

  • BAY STREET PHARMACY INC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Bay Street Pharmacy Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1471564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471564800000",
    "number": "1528513595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 368",
            "city": "ROSELAND",
            "state": "FL",
            "postal_code": "329570368",
            "telephone_number": "772-589-2043",
            "fax_number": "772-388-2628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7746 BAY ST",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "329583427",
            "telephone_number": "772-589-2043",
            "fax_number": "772-388-2628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAY STREET PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-19",
        "last_updated": "2016-08-19",
        "status": "A",
        "authorized_official_last_name": "TOLLE",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "772-589-2043"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "FL",
            "license": "PH8549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105269100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2163656",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105269103",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BAY STREET PHARMACY INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sebastian, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.