Provider Demographics
NPI:1568825404
Name:HAYS, ERIC HENRY (COTA)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:HENRY
Last Name:HAYS
Suffix:
Gender:M
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:243 PINECROFT DR.
Mailing Address - Street 2:
Mailing Address - City:TAYLORS
Mailing Address - State:SC
Mailing Address - Zip Code:29687
Mailing Address - Country:US
Mailing Address - Phone:864-421-4207
Mailing Address - Fax:
Practice Address - Street 1:243 PINECROFT DR
Practice Address - Street 2:
Practice Address - City:TAYLORS
Practice Address - State:SC
Practice Address - Zip Code:29687-2216
Practice Address - Country:US
Practice Address - Phone:864-421-4207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-29
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3535305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service