MEDICARE: DR. JAY P HANEY DOCTOR OF PHARMACY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	13310-040	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043269137
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAY P HANEY DOCTOR OF PHARMACY

Provider Business Mailing Address
First Line	:	W319N1019 BALSAM LN
Second Line	:
City	:	DELAFIELD
State	:	WI
Zip	:	53018-2633
Country	:	US
Telephone Number	:	262-719-5346
Fax Number	:

Provider Business Practice Location Address
First Line	:	8500 W CAPITOL DR
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53222-1869
Country	:	US
Telephone Number	:	414-463-1111
Fax Number	:	414-463-1112

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	03/07/2023

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