Individual provider Active NPI

Ejaz Hasan, RPH

  • Pharmacist
  • Norfolk, VA
National Provider Identifier
1780996819
Registry record updated May 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0202209206 Issued in VA
Practice address
3600 Tidewater Dr
Norfolk, VA 23509-1436
Phone
(757) 623-2706
Fax
(757) 623-5209
NPI assigned
Jul 6, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0202209206 VA Primary

Addresses

Primary practice location

3600 Tidewater Dr
Norfolk, VA 23509-1436

Mailing address

515 N Main St
Suffolk, VA 23434-4426
Phone (757) 539-9992

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
0202209206VAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Rite Aid of Virginia Inc Past Accepting new patients
Rite Aid of Virginia Inc Past Accepting new patients
Rite Aid of Virginia Inc Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1278374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368835200000",
    "number": "1780996819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 N MAIN ST",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234344426",
            "telephone_number": "757-539-9992",
            "fax_number": "757-539-0810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 TIDEWATER DR",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235091436",
            "telephone_number": "757-623-2706",
            "fax_number": "757-623-5209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASAN",
        "first_name": "EJAZ",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-06",
        "last_updated": "2013-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202209206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2013; 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.