Healthcare Provider Details

I. General information

NPI: 1194767715
Provider Name (Legal Business Name): HAYS DRUG STORE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 09/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 E MAIN ST
ATKINS AR
72823-4527
US

IV. Provider business mailing address

201 E MAIN ST
ATKINS AR
72823-4527
US

V. Phone/Fax

Practice location:
  • Phone: 479-641-1147
  • Fax: 479-641-1990
Mailing address:
  • Phone: 479-641-1147
  • Fax: 479-641-1990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberAR15388
License Number StateAR

VIII. Authorized Official

Name: BRYAN HAYS
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 479-641-1147