Provider Demographics
NPI:1871196741
Name:HAGHPARVAR, HALEH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:HALEH
Middle Name:
Last Name:HAGHPARVAR
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 N SANTA FE AVE
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73003-3603
Mailing Address - Country:US
Mailing Address - Phone:405-340-0522
Mailing Address - Fax:405-359-8853
Practice Address - Street 1:1301 N SANTA FE AVE
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73003-3603
Practice Address - Country:US
Practice Address - Phone:405-340-0522
Practice Address - Fax:405-359-8853
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-20
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK135571835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1760586958OtherCVS PHARMACY
1760586598OtherCVS PHARMACY