Healthcare Provider Details

I. General information

NPI: 1487205944
Provider Name (Legal Business Name): HAYAT PHARMACY 20 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2019
Last Update Date: 03/25/2024
Certification Date: 03/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

807 W LAYTON AVE STE B
MILWAUKEE WI
53221-2426
US

IV. Provider business mailing address

PO BOX 13337
MILWAUKEE WI
53213-0337
US

V. Phone/Fax

Practice location:
  • Phone: 414-533-2222
  • Fax: 414-533-0001
Mailing address:
  • Phone: 414-712-5200
  • Fax: 888-712-5200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. HASHIM ZAIBAK
Title or Position: PHARMACIST
Credential:
Phone: 414-712-5200