Provider Demographics
NPI:1457441099
Name:HAYEN APOTHECARY
Entity Type:Organization
Organization Name:HAYEN APOTHECARY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMOCIST
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:C
Authorized Official - Last Name:HAYEN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:785-770-7979
Mailing Address - Street 1:461 E POYNTZ AVE
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-5045
Mailing Address - Country:US
Mailing Address - Phone:785-770-7979
Mailing Address - Fax:785-539-0417
Practice Address - Street 1:461 E POYNTZ AVE
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-5045
Practice Address - Country:US
Practice Address - Phone:785-770-7979
Practice Address - Fax:785-539-0417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1100143336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy