Provider Demographics
NPI:1225360415
Name:HAAS, CHARLENE DENISE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:CHARLENE
Middle Name:DENISE
Last Name:HAAS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6540 MALL RD
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26501-8525
Mailing Address - Country:US
Mailing Address - Phone:304-983-6082
Mailing Address - Fax:
Practice Address - Street 1:6540 MALL RD
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26501-8525
Practice Address - Country:US
Practice Address - Phone:304-983-6082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-12
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV4948183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist