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NPI Code Detail

MEDICARE: HAYLEY HERZOG PHARMD

MEDICARE: HAYLEY HERZOG PHARMD
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
1183500000XPharmacist5302412692MI

General Provider Information

NPI Number : 1518585488
Entity Type Code : Individual
Provider Name (Legal Business Name) : HAYLEY HERZOG PHARMD
Provider Business Mailing Address
First Line : 1260 HILLTOP RD
Second Line :
City : SAINT JOSEPH
State : MI
Zip : 49085-2839
Country : US
Telephone Number : 269-983-0315
Fax Number :
Provider Business Practice Location Address
First Line : 1260 HILLTOP RD
Second Line :
City : SAINT JOSEPH
State : MI
Zip : 49085-2839
Country : US
Telephone Number : 269-983-0315
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2020
Last Update Date : 07/08/2020

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Directions to “ HAYLEY HERZOG PHARMD” Practice Location

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