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NPI Code Detail

MEDICARE: GEORGE R HAYNES PHARMD

MEDICARE: GEORGE R HAYNES 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
1183500000XPharmacistRP044807LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1RP044807LOTHERPAPHARMACIST LICENSE
2A1-0003916OTHERDEPHARMACIST LICENSE

General Provider Information

NPI Number : 1952308629
Entity Type Code : Individual
Provider Name (Legal Business Name) : GEORGE R HAYNES PHARMD
Provider Business Mailing Address
First Line : 4617 SIR GALAHAD DR
Second Line :
City : BROOKHAVEN
State : PA
Zip : 19015-1527
Country : US
Telephone Number : 610-447-8875
Fax Number :
Provider Business Practice Location Address
First Line : 701 N CLAYTON ST
Second Line : PHARMACY
City : WILMINGTON
State : DE
Zip : 19805-3165
Country : US
Telephone Number : 302-421-4295
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 07/17/2013

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