Provider Demographics
NPI:1689159352
Name:HAYS, BRYAN STEVEN (PHARMD)
Entity Type:Individual
Prefix:
First Name:BRYAN
Middle Name:STEVEN
Last Name:HAYS
Suffix:
Gender:M
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:PO BOX 155
Mailing Address - Street 2:
Mailing Address - City:ATKINS
Mailing Address - State:AR
Mailing Address - Zip Code:72823-0155
Mailing Address - Country:US
Mailing Address - Phone:479-641-7878
Mailing Address - Fax:479-641-2294
Practice Address - Street 1:1601B N CHURCH ST
Practice Address - Street 2:
Practice Address - City:ATKINS
Practice Address - State:AR
Practice Address - Zip Code:72823-3234
Practice Address - Country:US
Practice Address - Phone:479-641-7878
Practice Address - Fax:479-641-2294
Is Sole Proprietor?:No
Enumeration Date:2018-09-28
Last Update Date:2018-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD10091183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARPD10091OtherSTATE LICENSE