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General NPI Number Information
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NPI Number | 1336316512
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Entity Type | Organization
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Legal Business Name | HAYESVILLE PHARMACY LLC
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Dates
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Enumeration Date | 05/15/2008
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Last Update Date | 10/14/2013
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Provider Practice Location Address
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Address Line | 808 NC HWY 69
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City | HAYESVILLE
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State | NC
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Zip | 28904
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Country | US
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Telephone | 828-389-6900
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Fax | 828-389-6966
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Provider Business Mailing Address
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Address Line | PO BOX 1559
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City | HAYESVILLE
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State | NC
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Zip | 28904-1559
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Country | US
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Telephone | 828-389-6900
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Fax | 828-389-6966
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Authorized Official
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Title or Position | MEMBER LLC
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Name | ROBERT TURNER
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Credential | RPH
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Telephone | 828-389-6900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 10095
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License Number State | NC
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