Bayside RX LLC

Primary specialty

Managed Care Organization PharmacyTaxonomy code 3336M0003X

Legal business name

BAYSIDE RX LLC

Practice address

21411 41St Ave
Bayside, NY 11361-2133

Phone

(347) 749-8544

Fax

(718) 522-2388

NPI assigned

Apr 12, 2016

Last updated

Apr 12, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Miss Jaclyn Prisco, N/A

Title

President

Phone

(347) 749-8544

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1460419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460419200000",
    "number": "1558725853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21411 41ST AVE",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113612133",
            "telephone_number": "347-749-8544",
            "fax_number": "718-522-2388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21411 41ST AVE",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113612133",
            "telephone_number": "347-749-8544",
            "fax_number": "718-522-2388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSIDE RX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-12",
        "last_updated": "2016-04-12",
        "status": "A",
        "authorized_official_last_name": "PRISCO",
        "authorized_official_first_name": "JACLYN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "347-749-8544",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "N/A"
    },
    "taxonomies": [
        {
            "code": "3336M0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Managed Care Organization Pharmacy",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacy in Bayside, NY
• Providers in Bayside, NY by specialty
• Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 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.