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General NPI Number Information
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NPI Number | 1164419404
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Entity Type | Individual
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Provider Name | GARY LEE HAAS RPH
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Gender | Male
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Dates
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Enumeration Date | 10/03/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 17316 SHEPHERDSTOWN PIKE SHARPSBURG PHARMACY INC
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City | SHARPSBURG
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State | MD
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Zip | 21782-1626
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Country | US
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Telephone | 301-432-7223
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Fax | 301-432-4423
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Provider Business Mailing Address
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Address Line | 5709 RED HILL RD
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City | KEEDYSVILLE
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State | MD
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Zip | 21756-1461
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Country | US
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Telephone | 301-432-6814
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Fax | 301-432-2466
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 07531
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License Number State | MD
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