MEDICARE: DR. ANN MARIE RYAN HADDAD PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	10212	NE

General Provider Information

NPI Number	:	1063411130
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANN MARIE RYAN HADDAD PHARM.D.

Provider Business Mailing Address
First Line	:	308 S 52ND ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68132-3544
Country	:	US
Telephone Number	:	402-551-3786
Fax Number	:

Provider Business Practice Location Address
First Line	:	CREIGHTON UNIVERSITY SCHOOL OF PHARMACY & HEALTH P
Second Line	:	2500 CALIFORNIA PLAZA, HSL 107
City	:	OMAHA
State	:	NE
Zip	:	68178-0001
Country	:	US
Telephone Number	:	402-280-1263
Fax Number	:	402-280-1883

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	10/12/2008

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