Provider Demographics
NPI:1316008808
Name:HOUSTON, HAYDEN OAKES JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:HAYDEN
Middle Name:OAKES
Last Name:HOUSTON
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 155
Mailing Address - Street 2:
Mailing Address - City:HEBRON
Mailing Address - State:CT
Mailing Address - Zip Code:06248
Mailing Address - Country:US
Mailing Address - Phone:860-228-3436
Mailing Address - Fax:
Practice Address - Street 1:117 MAIN ST
Practice Address - Street 2:HEBRON PHARMACY INC
Practice Address - City:HEBRON
Practice Address - State:CT
Practice Address - Zip Code:06248
Practice Address - Country:US
Practice Address - Phone:860-228-3888
Practice Address - Fax:860-228-3391
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4704183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist