Provider Demographics
NPI:1043510027
Name:HAAS, ERIC CHRISTOPHER (RPH)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:CHRISTOPHER
Last Name:HAAS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7900 FORT HUNT RD
Mailing Address - Street 2:SAFEWAY 0878
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22308-1203
Mailing Address - Country:US
Mailing Address - Phone:703-765-0540
Mailing Address - Fax:703-660-5986
Practice Address - Street 1:7900 FORT HUNT RD
Practice Address - Street 2:SAFEWAY 0878
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22308-1203
Practice Address - Country:US
Practice Address - Phone:703-765-0540
Practice Address - Fax:703-660-5986
Is Sole Proprietor?:No
Enumeration Date:2010-10-25
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202205086183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist