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NPI Code Detail

MEDICARE: DR. ISABEL CLARE HAGEDORN PHARMD

MEDICARE:  DR. ISABEL CLARE HAGEDORN  PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist26023347AIN

General Provider Information

NPI Number : 1154629244
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ISABEL CLARE HAGEDORN PHARMD
Provider Business Mailing Address
First Line : 4600 SUNSET AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46208-3443
Country : US
Telephone Number : 317-940-6586
Fax Number :
Provider Business Practice Location Address
First Line : 4600 SUNSET AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46208-3443
Country : US
Telephone Number : 317-940-6586
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2011
Last Update Date : 11/03/2013

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Directions to “ DR. ISABEL CLARE HAGEDORN PHARMD” Practice Location

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