Healthcare Provider Details

I. General information

NPI: 1922266584
Provider Name (Legal Business Name): HAYES DRUG LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2008
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

689 FREEDOM AVE
NORTH TAZEWELL VA
24630-5168
US

IV. Provider business mailing address

PO BOX 69
TAZEWELL VA
24651
US

V. Phone/Fax

Practice location:
  • Phone: 276-988-4414
  • Fax: 276-988-5151
Mailing address:
  • Phone: 276-988-4414
  • Fax: 276-988-5151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number0201004237
License Number StateVA

VIII. Authorized Official

Name: THOMAS GASTON HAYES JR.
Title or Position: PHARMACIST IN CHARGE
Credential: RPH
Phone: 276-988-4414