Healthcare Provider Details

I. General information

NPI: 1376553172
Provider Name (Legal Business Name): ANGELINA SAGARSEE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANGELINA HAMEL

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 12/07/2020
Certification Date: 12/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 E DOUGLAS RD STE 412
MISHAWAKA IN
46545-1468
US

IV. Provider business mailing address

1609 E COLFAX AVE
SOUTH BEND IN
46617-2603
US

V. Phone/Fax

Practice location:
  • Phone: 574-335-6500
  • Fax:
Mailing address:
  • Phone: 574-229-8053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26022042A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: