Provider Demographics
NPI:1245348309
Name:HASKELL, MARSHALL DENNIS (RPH)
Entity type:Individual
Prefix:
First Name:MARSHALL
Middle Name:DENNIS
Last Name:HASKELL
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 1:7517 NW 25TH ST
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-8136
Mailing Address - Country:US
Mailing Address - Phone:954-346-6657
Mailing Address - Fax:954-782-6685
Practice Address - Street 1:60 NE 1ST ST
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33060-6602
Practice Address - Country:US
Practice Address - Phone:954-943-3111
Practice Address - Fax:954-782-6685
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS11331183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist