Provider Demographics
NPI:1982640272
Name:HAYES, BRANDON SCOTT (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:SCOTT
Last Name:HAYES
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 1:1101 GRANDVIEW AVE
Mailing Address - Street 2:APT A
Mailing Address - City:TOMAH
Mailing Address - State:WI
Mailing Address - Zip Code:54660-3123
Mailing Address - Country:US
Mailing Address - Phone:800-872-8662
Mailing Address - Fax:608-372-1715
Practice Address - Street 1:500 E VETERANS ST
Practice Address - Street 2:
Practice Address - City:TOMAH
Practice Address - State:WI
Practice Address - Zip Code:54660-3105
Practice Address - Country:US
Practice Address - Phone:800-872-8662
Practice Address - Fax:608-372-1715
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP000066461835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy