Provider Demographics
NPI:1598540122
Name:HYMAN, KAILYA MARSHE (PHARMD)
Entity Type:Individual
Prefix:
First Name:KAILYA
Middle Name:MARSHE
Last Name:HYMAN
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 1:1110 RIVERWALK WAY
Mailing Address - Street 2:
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-9384
Mailing Address - Country:US
Mailing Address - Phone:839-810-8810
Mailing Address - Fax:
Practice Address - Street 1:1330 DUTCH FORK RD
Practice Address - Street 2:
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063-8825
Practice Address - Country:US
Practice Address - Phone:803-749-1666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC44100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist