1114010527 NPI number — TAOHEED HASAN PHARMACIST

Table of content: TAOHEED HASAN PHARMACIST (NPI 1114010527)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114010527 NPI number — TAOHEED HASAN PHARMACIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HASAN
Provider First Name:
TAOHEED
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHARMACIST
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114010527
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/17/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1324 WEST AVE J
Provider Second Line Business Mailing Address:
SUITE 7
Provider Business Mailing Address City Name:
LANCASTER
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93534
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
661-942-8777
Provider Business Mailing Address Fax Number:
661-942-8795

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1324 WEST AVE J
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93534
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-942-8777
Provider Business Practice Location Address Fax Number:
661-942-8795
Provider Enumeration Date:
09/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  RPH38785 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 333600000X , with the licence number: PHY468660 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 5614246 . This is a "NABP" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: PHA468660 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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