MEDICARE: LORNA IMPERIAL LAGARDE RPH

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
1	183500000X	Pharmacist	PHA23845	DC

General Provider Information

NPI Number	:	1255316196
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORNA IMPERIAL LAGARDE RPH

Provider Business Mailing Address
First Line	:	5801 DEFENSE PENTAGON
Second Line	:	DTHC PHARMACY SERVICES
City	:	WASHINGTON
State	:	DC
Zip	:	20310-0001
Country	:	US
Telephone Number	:	703-692-8694
Fax Number	:	703-692-0899

Provider Business Practice Location Address
First Line	:	5801 DEFENSE PENTAGON
Second Line	:	DTHC PHARMACY SERVICES DTMC PENTAGON
City	:	WASHINGTON
State	:	DC
Zip	:	20310-0001
Country	:	US
Telephone Number	:	703-692-8694
Fax Number	:	703-692-0899

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	07/08/2007

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