Provider Demographics
NPI:1730659962
Name:HAYAT PHARMACY 12
Entity Type:Organization
Organization Name:HAYAT PHARMACY 12
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HASHIM
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAIBAK
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:414-744-7777
Mailing Address - Street 1:PO BOX 13337
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53213-0337
Mailing Address - Country:US
Mailing Address - Phone:414-744-7777
Mailing Address - Fax:414-744-7776
Practice Address - Street 1:5911 S PACKARD AVE
Practice Address - Street 2:
Practice Address - City:CUDAHY
Practice Address - State:WI
Practice Address - Zip Code:53110-3025
Practice Address - Country:US
Practice Address - Phone:414-744-7777
Practice Address - Fax:414-744-7776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-30
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy