Provider Demographics
NPI:1144776725
Name:HASSAN, AMR (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:AMR
Middle Name:
Last Name:HASSAN
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1610 W LITTLE CREEK RD
Mailing Address - Street 2:APT 204
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23505-1886
Mailing Address - Country:US
Mailing Address - Phone:757-729-5142
Mailing Address - Fax:
Practice Address - Street 1:1610 W LITTLE CREEK RD
Practice Address - Street 2:APT 204
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23505
Practice Address - Country:US
Practice Address - Phone:757-729-5142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202215153183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist