1295377703 NPI number — HAYAT PHARMACY 21 LLC.

Table of content: (NPI 1295377703)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295377703 NPI number — HAYAT PHARMACY 21 LLC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HAYAT PHARMACY 21 LLC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HAYAT PHARMACY 21
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1295377703
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/05/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 13337
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MILWAUKEE
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53213-0337
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
414-712-5200
Provider Business Mailing Address Fax Number:
888-830-0714

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2500 W LAYTON AVE STE 150
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MILWAUKEE
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53221-5421
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
414-712-5200
Provider Business Practice Location Address Fax Number:
888-830-0714
Provider Enumeration Date:
10/16/2019

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ZAIBAK
Authorized Official First Name:
HASHIM
Authorized Official Middle Name:
Authorized Official Title or Position:
PHARMACIST OWNER
Authorized Official Telephone Number:
414-712-5200

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)