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JAYME HAGAN PHARMD
>> Pharmacist >> Pharmacy Service ProvidersRegistrant NPI Number: 1043563521
Individual Registrant: JAYME HAGAN PHARMD
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
520 MAIN ST WALSENBURG, CO 81089-2036 US
Tel: 719-738-1130 Fax: --
Tel: 719-738-1130 Fax: --
Contact information for business:
520 MAIN ST WALSENBURG, CO 81089-2036 US
Tel: -- Fax: --
Tel: -- Fax: --
Registration Information:
NPI: 1043563521
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 183500000X | Pharmacy Service Providers Pharmacist | CO | 16120 |
| N | 183500000X | Pharmacy Service Providers Pharmacist | NM | RP00007812 |
| N | 183500000X | Pharmacy Service Providers Pharmacist | NE | 11632 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
