Provider Demographics
NPI:1508490772
Name:HAYES, RILEY (PHARMD)
Entity Type:Individual
Prefix:
First Name:RILEY
Middle Name:
Last Name:HAYES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:732 PACKER DR
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:WI
Mailing Address - Zip Code:54016-7693
Mailing Address - Country:US
Mailing Address - Phone:605-321-5087
Mailing Address - Fax:
Practice Address - Street 1:1047 N MAIN ST
Practice Address - Street 2:
Practice Address - City:RIVER FALLS
Practice Address - State:WI
Practice Address - Zip Code:54022-1596
Practice Address - Country:US
Practice Address - Phone:715-426-4089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-26
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN124384183500000X
WI19996-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist