Provider Demographics
NPI:1780989798
Name:VO, HAIYEN A (PHARMD)
Entity type:Individual
Prefix:DR
First Name:HAIYEN
Middle Name:A
Last Name:VO
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 1:3551 CASSOPOLIS ST
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46514-6743
Mailing Address - Country:US
Mailing Address - Phone:574-206-0285
Mailing Address - Fax:574-266-5819
Practice Address - Street 1:3551 CASSOPOLIS ST
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46514-6743
Practice Address - Country:US
Practice Address - Phone:574-206-0285
Practice Address - Fax:574-266-5819
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-21
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26020597A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN26020598AOtherPHARMACIST LICENSE