Provider Demographics
NPI:1245993906
Name:TAYE, OLEYAD SEYUM (PHARM D)
Entity type:Individual
Prefix:
First Name:OLEYAD
Middle Name:SEYUM
Last Name:TAYE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5440 NW 64TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64151-2415
Mailing Address - Country:US
Mailing Address - Phone:816-741-5576
Mailing Address - Fax:816-587-3566
Practice Address - Street 1:5440 NW 64TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64151-2415
Practice Address - Country:US
Practice Address - Phone:816-741-5576
Practice Address - Fax:816-587-3566
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-20
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021035021183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist