MEDICARE: HAAS PHARMACY INC

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	3336C0003X	Community/Retail Pharmacy	027742	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	3352731	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1396766358
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAAS PHARMACY INC

Provider Business Mailing Address
First Line	:	62 ORANGE TPKE
Second Line	:
City	:	SLOATSBURG
State	:	NY
Zip	:	10974-2317
Country	:	US
Telephone Number	:	845-753-9675
Fax Number	:	845-753-2414

Provider Business Practice Location Address
First Line	:	62 ORANGE TPKE
Second Line	:
City	:	SLOATSBURG
State	:	NY
Zip	:	10974-2317
Country	:	US
Telephone Number	:	845-753-9675
Fax Number	:	845-753-2414

Authorized Official
Title or Position	:	OWNER
Name	:	LARRY HAAS
Credential	:
Telephone Number	:	845-753-9675

Provider Enumeration Date	:	07/22/2006
Last Update Date	:	04/01/2011

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Directions to “HAAS PHARMACY INC ” Practice Location

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