Healthcare Provider Details

I. General information

NPI: 1861018723
Provider Name (Legal Business Name): KATRINA VIGEANT PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2020
Last Update Date: 06/17/2020
Certification Date: 06/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 COMPUTER DR
HAVERHILL MA
01832-1236
US

IV. Provider business mailing address

35 COMPUTER DR
HAVERHILL MA
01832-1236
US

V. Phone/Fax

Practice location:
  • Phone: 989-377-9004
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHCY00918
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH238919
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: