Provider Demographics
NPI:1558641449
Name:HAAS, BRANDON (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:
Last Name:HAAS
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E PIKE ST
Mailing Address - Street 2:SUITE B, PO BOX 882
Mailing Address - City:JACKSON CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:45334-6000
Mailing Address - Country:US
Mailing Address - Phone:937-596-8100
Mailing Address - Fax:937-596-8108
Practice Address - Street 1:101 E PIKE ST
Practice Address - Street 2:SUITE B
Practice Address - City:JACKSON CENTER
Practice Address - State:OH
Practice Address - Zip Code:45334-6000
Practice Address - Country:US
Practice Address - Phone:937-596-8100
Practice Address - Fax:937-596-8108
Is Sole Proprietor?:No
Enumeration Date:2011-08-23
Last Update Date:2014-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26024778A183500000X
OH03331294183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist