MEDICARE: ERIC CHRISTOPHER HAAS RPH

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	0202205086	VA

General Provider Information

NPI Number	:	1043510027
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC CHRISTOPHER HAAS RPH

Provider Business Mailing Address
First Line	:	7900 FORT HUNT RD
Second Line	:	SAFEWAY 0878
City	:	ALEXANDRIA
State	:	VA
Zip	:	22308-1203
Country	:	US
Telephone Number	:	703-765-0540
Fax Number	:	703-660-5986

Provider Business Practice Location Address
First Line	:	7900 FORT HUNT RD
Second Line	:	SAFEWAY 0878
City	:	ALEXANDRIA
State	:	VA
Zip	:	22308-1203
Country	:	US
Telephone Number	:	703-765-0540
Fax Number	:	703-660-5986

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

Provider Enumeration Date	:	10/25/2010
Last Update Date	:	10/25/2010

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