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A pharmacy owned by a managed care organization (MCO) used by pharmacists for the compounding and dispensing of medicinal preparations to that MCO?s covered members only.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Managed Care Organization Pharmacy |
3336M0003X | 58 | Medical Supply Company with Pharmacist |
| NPI Number | 1558725853 |
| LBN Legal business name | BAYSIDE RX LLC |
| Authorized official | JACLYN PRISCO - (PRESIDENT) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 04/12/2016 |
| Last updated | 04/12/2016 - About 10 years ago |
| Identifiers | n/a |
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BAYSIDE RX LLC
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BAYSIDE RX LLC