Healthcare Provider Details

I. General information

NPI: 1215100821
Provider Name (Legal Business Name): GRETCHEN ANNE HAYDEN DOCTOR OF PHARMACY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GRETCHEN BAKER HAYDEN DOCTOR OF PHARMACY

II. Dates (important events)

Enumeration Date: 04/04/2008
Last Update Date: 02/14/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

KYCARE PHARMACY 145 119 E CLAY STREET
CLINTON KY
42031
US

IV. Provider business mailing address

325 BALLARD RD
MAYFIELD KY
42066-9466
US

V. Phone/Fax

Practice location:
  • Phone: 270-653-2151
  • Fax: 270-653-2004
Mailing address:
  • Phone: 270-705-8551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number013293
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: