Provider Demographics
NPI:1467570036
Name:NAYAK, HIREN (RPH)
Entity Type:Individual
Prefix:
First Name:HIREN
Middle Name:
Last Name:NAYAK
Suffix:
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 1:140 JONES CREEK CIR
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-7612
Mailing Address - Country:US
Mailing Address - Phone:864-844-9370
Mailing Address - Fax:
Practice Address - Street 1:2116 N HIGHWAY 81
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-1532
Practice Address - Country:US
Practice Address - Phone:864-844-9370
Practice Address - Fax:864-844-9027
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302034308183500000X
SC37680183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC718255Medicaid