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NPI Code Detail

MEDICARE: AMY A HAGGERTY PHARM D

MEDICARE: AMY A HAGGERTY PHARM D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist5179SD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15179OTHERSDSTATE PHARMACIST LICENSE

General Provider Information

NPI Number : 1255416707
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY A HAGGERTY PHARM D
Provider Business Mailing Address
First Line : 2209 S CHESAPEAKE CIR
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57106-4552
Country : US
Telephone Number : 605-361-6206
Fax Number :
Provider Business Practice Location Address
First Line : 4901 N 4TH AVE
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57104-0444
Country : US
Telephone Number : 605-373-0100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2006
Last Update Date : 07/08/2007

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Directions to “ AMY A HAGGERTY PHARM D” Practice Location

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