Provider Demographics
NPI:1366995250
Name:BLOCK, HAYDEN ROSS (PHARMD,)
Entity type:Individual
Prefix:DR
First Name:HAYDEN
Middle Name:ROSS
Last Name:BLOCK
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 1:555 W WACKERLY ST STE 600
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-4721
Mailing Address - Country:US
Mailing Address - Phone:989-488-5235
Mailing Address - Fax:
Practice Address - Street 1:555 W WACKERLY ST STE 600
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-4721
Practice Address - Country:US
Practice Address - Phone:989-488-5235
Practice Address - Fax:989-488-5236
Is Sole Proprietor?:No
Enumeration Date:2016-07-27
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53020413801835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care