Provider Demographics
NPI:1053767483
Name:HAUN, JOHN T (RPH)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:T
Last Name:HAUN
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:US ROUTE 52
Mailing Address - Street 2:
Mailing Address - City:BLUEWELL
Mailing Address - State:WV
Mailing Address - Zip Code:24701
Mailing Address - Country:US
Mailing Address - Phone:304-589-7732
Mailing Address - Fax:
Practice Address - Street 1:US ROUTE 52
Practice Address - Street 2:
Practice Address - City:BLUEWELL
Practice Address - State:WV
Practice Address - Zip Code:24701
Practice Address - Country:US
Practice Address - Phone:304-589-7732
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-04
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0003464183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist