MEDICARE: SAMANTHA HAYDEN

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
1	183500000X	Pharmacist	RP449471	PA

General Provider Information

NPI Number	:	1235507807
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA HAYDEN

Provider Business Mailing Address
First Line	:	3701 PENN AVE
Second Line	:	3
City	:	PITTSBURGH
State	:	PA
Zip	:	15201-1225
Country	:	US
Telephone Number	:	724-681-7037
Fax Number	:

Provider Business Practice Location Address
First Line	:	3701 PENN AVE
Second Line	:	3
City	:	PITTSBURGH
State	:	PA
Zip	:	15201-1225
Country	:	US
Telephone Number	:	724-681-7037
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2015
Last Update Date	:	09/12/2015

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Directions to “ SAMANTHA HAYDEN ” Practice Location

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