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General NPI Number Information
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NPI Number | 1962564583
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Entity Type | Organization
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Legal Business Name | HAYWARD PHARMACY INC.
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 09/03/2010
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Provider Practice Location Address
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Address Line | 9130 W NORTH AVE
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City | WAUWATOSA
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State | WI
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Zip | 53226-2623
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Country | US
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Telephone | 414-258-9550
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Fax | 414-258-1088
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Provider Business Mailing Address
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Address Line | 9130 W. NORTH AVE
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City | WAUWATOSA
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State | WI
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Zip | 53226-2696
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Country | US
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Telephone | 414-258-9550
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Fax | 414-258-1088
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. TIMOTHY JAMES WALSH
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Credential | RPH
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Telephone | 414-640-7129
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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 | 5343
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5343-42
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License Number State | WI
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