Individual provider Active NPI

Amanuel Haileab

  • Pharmacist
  • Alexandria, VA
National Provider Identifier
1114045606
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0202012981 Issued in VA
Practice address
6400 Lansdown Center
CVS Pharmacy
Alexandria, VA 22315
Phone
(703) 541-3565
Fax
(703) 339-0875
NPI assigned
Mar 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0202012981 VA Primary

Addresses

Primary practice location

6400 Lansdown Center
CVS Pharmacy
Alexandria, VA 22315

Mailing address

266 Kentucky Ave SE # a
Washington, DC 20003-2318
Phone (703) 629-0760

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0202012981VAMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114045606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "266 KENTUCKY AVE SE # A",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200032318",
            "telephone_number": "703-629-0760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 LANSDOWN CENTER",
            "address_2": "CVS PHARMACY",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "22315",
            "telephone_number": "703-541-3565",
            "fax_number": "703-339-0875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAILEAB",
        "first_name": "AMANUEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202012981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.