Provider Demographics
NPI:1003404989
Name:TATRO, HAYLEY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:HAYLEY
Middle Name:
Last Name:TATRO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:352 E 8TH ST APT 1
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02127-3461
Mailing Address - Country:US
Mailing Address - Phone:608-513-5033
Mailing Address - Fax:
Practice Address - Street 1:6439 GARNERS FERRY RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29209-1638
Practice Address - Country:US
Practice Address - Phone:803-776-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-06
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH2387301835C0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835C0205XPharmacy Service ProvidersPharmacistCritical CareGroup - Single Specialty