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General NPI Number Information
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NPI Number | 1124432059
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Entity Type | Individual
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Provider Name | MARK HAGAR JR. PHARMD
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Gender | Male
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Dates
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Enumeration Date | 06/18/2014
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Last Update Date | 06/18/2014
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Provider Practice Location Address
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Address Line | 223 NORTH ST
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City | CALAIS
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State | ME
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Zip | 04619-1619
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Country | US
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Telephone | 207-454-2262
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Fax |
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Provider Business Mailing Address
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Address Line | 18 BIRCH LN
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City | ALEXANDER
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State | ME
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Zip | 04694-6306
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PR12981
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License Number State | ME
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