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JAYME HAGAN PHARMD

>> Pharmacist >> Pharmacy Service Providers

Registrant NPI Number: 1043563521

Individual Registrant:
 JAYME  HAGAN PHARMD
Gender: M
Sole Proprietor

Location and contact information for practice:
520 MAIN ST  WALSENBURG, CO 81089-2036 US
Tel: 719-738-1130  Fax: --

Contact information for business:
520 MAIN ST  WALSENBURG, CO 81089-2036 US
Tel: --  Fax: --

Registration Information:
NPI: 1043563521
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y183500000XPharmacy Service Providers
Pharmacist
CO16120
N183500000XPharmacy Service Providers
Pharmacist
NMRP00007812
N183500000XPharmacy Service Providers
Pharmacist
NE11632

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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