Provider Demographics
NPI:1770864258
Name:MEADORS, HAYLEY JANE (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:HAYLEY
Middle Name:JANE
Last Name:MEADORS
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 1:8408 NW 106TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-4047
Mailing Address - Country:US
Mailing Address - Phone:405-470-2157
Mailing Address - Fax:
Practice Address - Street 1:5120 N MAY AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-3504
Practice Address - Country:US
Practice Address - Phone:405-942-2471
Practice Address - Fax:405-942-6332
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-29
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK13545183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist