Healthcare Provider Details

I. General information

NPI: 1588752463
Provider Name (Legal Business Name): JENNIFER JOYCE DAGGETT PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 1ST AVE SE #202
ABERDEEN SD
57401-4602
US

IV. Provider business mailing address

12934 PRAIRIEWOOD DR
ABERDEEN SD
57401-8104
US

V. Phone/Fax

Practice location:
  • Phone: 605-725-4001
  • Fax: 605-725-2349
Mailing address:
  • Phone: 605-225-3964
  • Fax: 605-725-2349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5148
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: