Paul D Hayse

Primary specialty

PharmacyTaxonomy code 333600000X

License

054-00222 Issued in IL

Legal business name

PAUL D HAYSE

Practice address

1400 W Main St
202 April Avenue
Carmi, IL 62821-1387

Phone

(618) 382-4636

Fax

(618) 382-7970

NPI assigned

Oct 11, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jerry Mayberry, R.PH.

Title

Pharmacist-in-Charge/Manager

Phone

(618) 382-4636

Specialties & licenses 1

Addresses

Other names 1

• Pauls Pharmacy Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962490185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 W MAIN ST",
            "city": "CARMI",
            "state": "IL",
            "postal_code": "628211387",
            "telephone_number": "618-382-4636",
            "fax_number": "618-382-7970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 W MAIN ST",
            "address_2": "202 APRIL AVENUE",
            "city": "CARMI",
            "state": "IL",
            "postal_code": "628211387",
            "telephone_number": "618-382-4636",
            "fax_number": "618-382-7970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL D HAYSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MAYBERRY",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "PHARMACIST-IN-CHARGE/MANAGER",
        "authorized_official_telephone_number": "618-382-4636",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "IL",
            "license": "054-00222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pauls Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pharmacy in Carmi, IL
• Providers in Carmi, IL by specialty
• Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.