MEDICARE: JUDITH HAYDEN GARRIGAN RPH

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
1	183500000X	Pharmacist	16555	MA

General Provider Information

NPI Number	:	1760578421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDITH HAYDEN GARRIGAN RPH

Provider Business Mailing Address
First Line	:	15 MASSACHUSETTS AVENUE
Second Line	:
City	:	WALPOLE
State	:	MA
Zip	:	02081
Country	:	US
Telephone Number	:	508-668-7835
Fax Number	:

Provider Business Practice Location Address
First Line	:	150 SOUTH HUNTINGTON AVE
Second Line	:
City	:	JAMAICA PLAIN
State	:	MA
Zip	:	02130-4893
Country	:	US
Telephone Number	:	857-364-5367
Fax Number	:	857-364-4428

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	07/08/2007

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