Healthcare Provider Details

I. General information

NPI: 1487054763
Provider Name (Legal Business Name): LAUREN CATHERINE HAGGERTY PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2014
Last Update Date: 04/13/2022
Certification Date: 04/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9101 FRANKLIN SQUARE DR STE 300
ROSEDALE MD
21237-3966
US

IV. Provider business mailing address

4701 N CHARLES ST
BALTIMORE MD
21210-2404
US

V. Phone/Fax

Practice location:
  • Phone: 443-777-2000
  • Fax:
Mailing address:
  • Phone: 410-532-5082
  • Fax: 844-411-6898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202215198
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number24161
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: