Provider Demographics
NPI:1093280513
Name:HAYAT PHARMACY 6 LLC
Entity Type:Organization
Organization Name:HAYAT PHARMACY 6 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HASHIM
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAIBAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-712-5200
Mailing Address - Street 1:PO BOX 13337
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53213-0337
Mailing Address - Country:US
Mailing Address - Phone:414-712-5200
Mailing Address - Fax:414-455-0171
Practice Address - Street 1:5233 S 27TH ST STE 101
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53221-3764
Practice Address - Country:US
Practice Address - Phone:414-270-4444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HAYAT PHARMACY 6, LLC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-10-11
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1316353626Medicaid