Provider Demographics
NPI:1710087432
Name:HAYEN PHARMACIES, P.A.
Entity Type:Organization
Organization Name:HAYEN PHARMACIES, P.A.
Other - Org Name:PAUL'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:HAYEN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:785-539-1717
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:785-539-1717
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:785-539-1717
Practice Address - Fax:785-539-0417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-23
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS8241333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100440060AMedicaid
KS100440060BMedicaid
KS1715347OtherNCAP
SC0770340001Medicare ID - Type Unspecified