Provider Demographics
NPI:1033546817
Name:HAYAT PHARMACY 4 LLC
Entity Type:Organization
Organization Name:HAYAT PHARMACY 4 LLC
Other - Org Name:HAYAT PHARMACY #4
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PIC
Authorized Official - Prefix:
Authorized Official - First Name:HASHIM
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAIBAK
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:414-678-9798
Mailing Address - Street 1:5434 W CAPITOL DR
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53216-2298
Mailing Address - Country:US
Mailing Address - Phone:414-817-1111
Mailing Address - Fax:414-817-1110
Practice Address - Street 1:5434 W CAPITOL DR
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53216-2298
Practice Address - Country:US
Practice Address - Phone:414-817-1111
Practice Address - Fax:414-817-1110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-11
Last Update Date:2020-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9227-423336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2142399OtherPK