Provider Demographics
NPI:1083901979
Name:HAYES, PATRICK RS (PHARMD)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:RS
Last Name:HAYES
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 N COLE RD
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-8563
Mailing Address - Country:US
Mailing Address - Phone:208-375-8278
Mailing Address - Fax:208-322-7374
Practice Address - Street 1:1520 N COLE RD
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-8563
Practice Address - Country:US
Practice Address - Phone:208-375-8278
Practice Address - Fax:208-322-7374
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-30
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP6094183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist