Healthcare Provider Details

I. General information

NPI: 1841783370
Provider Name (Legal Business Name): EMMETT HAYES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2018
Last Update Date: 06/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

874 PURCHASE ST
NEW BEDFORD MA
02740-6232
US

IV. Provider business mailing address

65 SNELL RD
LITTLE COMPTON RI
02837-1831
US

V. Phone/Fax

Practice location:
  • Phone: 508-992-2422
  • Fax:
Mailing address:
  • Phone: 401-835-1007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH23265
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: