Provider Demographics
NPI:1013400944
Name:HAYES, GREGORY CHARLES (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:CHARLES
Last Name:HAYES
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24892 JOHN J WILLIAMS HWY
Mailing Address - Street 2:
Mailing Address - City:MILLSBORO
Mailing Address - State:DE
Mailing Address - Zip Code:19966-4939
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:24892 JOHN J WILLIAMS HWY
Practice Address - Street 2:
Practice Address - City:MILLSBORO
Practice Address - State:DE
Practice Address - Zip Code:19966-4939
Practice Address - Country:US
Practice Address - Phone:302-947-1204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-14
Last Update Date:2018-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25430183500000X
DEA10005153183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEA10005153OtherDELAWARE BOARD OF PHARMACY
MD25430OtherMARYLAND STATE BOARD OF PHARMACY