Provider Demographics
NPI:1275301806
Name:TARVER, HAYDEN CHRIS (PHARMD)
Entity Type:Individual
Prefix:
First Name:HAYDEN
Middle Name:CHRIS
Last Name:TARVER
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 1:4600 OLEANDER DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-5149
Mailing Address - Country:US
Mailing Address - Phone:910-392-1921
Mailing Address - Fax:
Practice Address - Street 1:4600 OLEANDER DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-5149
Practice Address - Country:US
Practice Address - Phone:910-392-1921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-13
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC32802183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist