Organization
PAUL D HAYSE
Active
Other names
Pauls Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY MAYBERRY R.PH. (PHARMACIST-IN-CHARGE/MANAGER)
(618) 382-4636
Entity
Organization
Contact information
Practice address
1400 W MAIN ST, 202 APRIL AVENUE, CARMI, IL 62821-1387
(618) 382-4636
(618) 382-7970
Mailing address
1400 W MAIN ST, CARMI, IL 62821-1387
(618) 382-4636
(618) 382-7970
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
054-00222
IL
Other
Enumeration date
10/11/2005
Last updated
08/22/2020
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