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NPI Code Detail

MEDICARE: MR. TIMOTHY ALDEN HAYES R.PH.

MEDICARE: MR. TIMOTHY ALDEN HAYES R.PH.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist16392TX
2183500000XPharmacistPS 26488FL

General Provider Information

NPI Number : 1215250840
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. TIMOTHY ALDEN HAYES R.PH.
Provider Business Mailing Address
First Line : 5420 PALOMA BLANCA DR
Second Line :
City : FORT WORTH
State : TX
Zip : 76179-7500
Country : US
Telephone Number : 817-237-5016
Fax Number : 817-238-7313
Provider Business Practice Location Address
First Line : 5420 PALOMA BLANCA DR
Second Line :
City : FORT WORTH
State : TX
Zip : 76179-7500
Country : US
Telephone Number : 817-237-5016
Fax Number : 817-238-7313
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2010
Last Update Date : 03/10/2010

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