1215100821 NPI number — DR. GRETCHEN ANNE HAYDEN DOCTOR OF PHARMACY

Table of content: DR. GRETCHEN ANNE HAYDEN DOCTOR OF PHARMACY (NPI 1215100821)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215100821 NPI number — DR. GRETCHEN ANNE HAYDEN DOCTOR OF PHARMACY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAYDEN
Provider First Name:
GRETCHEN
Provider Middle Name:
ANNE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DOCTOR OF PHARMACY
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HAYDEN
Provider Other First Name:
GRETCHEN
Provider Other Middle Name:
BAKER
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DOCTOR OF PHARMACY
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1215100821
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/14/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
325 BALLARD RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MAYFIELD
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
42066-9466
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
270-705-8551
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
KYCARE PHARMACY 145
Provider Second Line Business Practice Location Address:
119 E CLAY STREET
Provider Business Practice Location Address City Name:
CLINTON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42031
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-653-2151
Provider Business Practice Location Address Fax Number:
270-653-2004
Provider Enumeration Date:
04/04/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  013293 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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