Healthcare Provider Details

I. General information

NPI: 1104412022
Provider Name (Legal Business Name): HAYLEY KATEON PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2020
Last Update Date: 12/15/2020
Certification Date: 12/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 N BROADWAY ST
BALTIMORE MD
21287-0019
US

IV. Provider business mailing address

401 N BROADWAY WEINBERG PHARMACY 2430
BALTIMORE MD
21287
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-0000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835C0205X
TaxonomyCritical Care Pharmacist
License Number17794
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: