Provider Demographics
NPI:1770179244
Name:HAJI, AWALE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AWALE
Middle Name:
Last Name:HAJI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2611 PLEASANT AVE APT 203
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-1444
Mailing Address - Country:US
Mailing Address - Phone:612-229-1272
Mailing Address - Fax:
Practice Address - Street 1:1010 W LAKE ST
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-2860
Practice Address - Country:US
Practice Address - Phone:612-822-1297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-17
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN121589183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist