Provider Demographics
NPI:1407266125
Name:HASKEL, BENJAMIN (RPH)
Entity Type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:
Last Name:HASKEL
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 1:1167 E CLINTON TRL
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:MI
Mailing Address - Zip Code:48813-7318
Mailing Address - Country:US
Mailing Address - Phone:517-541-9210
Mailing Address - Fax:517-541-9265
Practice Address - Street 1:1167 E CLINTON TRL
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:MI
Practice Address - Zip Code:48813-7318
Practice Address - Country:US
Practice Address - Phone:517-541-9210
Practice Address - Fax:517-541-9265
Is Sole Proprietor?:No
Enumeration Date:2014-05-02
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53020356061835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy