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General NPI Number Information
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NPI Number | 1851669543
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Entity Type | Individual
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Provider Name | RONALD S HAGEN RPH
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Gender | Male
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Dates
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Enumeration Date | 12/08/2011
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Last Update Date | 12/08/2011
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Provider Practice Location Address
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Address Line | 900 1ST AVE
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City | WOODRUFF
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State | WI
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Zip | 54568-9467
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Country | US
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Telephone | 715-358-7084
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Fax |
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Provider Business Mailing Address
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Address Line | 482N OLD HIGHWAY 182
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City | PARK FALLS
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State | WI
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Zip | 54552
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Country | US
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Telephone | 715-583-9944
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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 | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 8719-040
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License Number State | WI
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