Provider Demographics
NPI:1063522191
Name:HAYS, JOHN BRADLEY (RPH)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:BRADLEY
Last Name:HAYS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6211 EAST WATERFORD BLVD
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715
Mailing Address - Country:US
Mailing Address - Phone:812-474-3671
Mailing Address - Fax:812-474-3660
Practice Address - Street 1:6211 E WATERFORD BLVD.
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715
Practice Address - Country:US
Practice Address - Phone:812-474-3671
Practice Address - Fax:812-474-3660
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12248183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist