Active NPI
Demilade Benjamin Haastrup, PHARMD
- Pharmacist
- Washington, DC
National Provider Identifier
1962090316
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH100004022
- Practice address
- 111 Michigan Ave NW
Washington, DC 20010-2916 - Phone
- (513) 693-9585
- NPI assigned
- Dec 31, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH100004022 | DC | Primary |
Addresses
Primary practice location
111 Michigan Ave NW
Washington, DC 20010-2916
Mailing address
1151 4TH St SW Apt 617
Washington, DC 20024-2356
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PH100004022 | Other | DC | DC BOARD OF PHARMACY |
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH100004022 | DC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609372800000",
"number": "1962090316",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1151 4TH ST SW APT 617",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200242356"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 MICHIGAN AVE NW",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200102916",
"telephone_number": "513-693-9585"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAASTRUP",
"first_name": "DEMILADE",
"middle_name": "BENJAMIN",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-31",
"last_updated": "2020-12-31",
"certification_date": "2020-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "DC",
"license": "PH100004022",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DC BOARD OF PHARMACY",
"identifier": "PH100004022",
"state": "DC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.