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General NPI Number Information
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NPI Number | 1902296346
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Entity Type | Organization
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Legal Business Name | HAYSVILLE SPECIALTY PHARMACY
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Dates
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Enumeration Date | 01/23/2015
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Last Update Date | 02/12/2016
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Provider Practice Location Address
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Address Line | 133 N MAIN ST
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City | HAYSVILLE
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State | KS
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Zip | 67060-1202
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Country | US
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Telephone | 316-524-4234
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Fax | 316-524-1630
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Provider Business Mailing Address
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Address Line | 145 N MAIN ST
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City | HAYSVILLE
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State | KS
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Zip | 67060-1202
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Country | US
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Telephone | 316-524-4234
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Fax | 316-524-1630
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Authorized Official
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Title or Position | MANAGER
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Name | AMR ABUALNADI
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Credential |
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Telephone | 316-524-4234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State | KS
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