Provider Demographics
NPI:1902129547
Name:HAYES PHARMACY INC
Entity Type:Organization
Organization Name:HAYES PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUANN
Authorized Official - Middle Name:EDWARDS
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-237-5016
Mailing Address - Street 1:5420 PALOMA BLANCA DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76179-7500
Mailing Address - Country:US
Mailing Address - Phone:817-237-5016
Mailing Address - Fax:817-238-7313
Practice Address - Street 1:5420 PALOMA BLANCA DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76179-7500
Practice Address - Country:US
Practice Address - Phone:817-237-5016
Practice Address - Fax:817-238-7313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-10
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12629333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy