MEDICARE: MICHAEL HAGAN 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	14368	MD

General Provider Information

NPI Number	:	1366571283
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL HAGAN RPH

Provider Business Mailing Address
First Line	:	PO BOX 54
Second Line	:
City	:	LISBON
State	:	MD
Zip	:	21765-0054
Country	:	US
Telephone Number	:	443-927-1788
Fax Number	:

Provider Business Practice Location Address
First Line	:	111 MICHIGAN AVENUE NW, 4 MAIN SUITE 4847
Second Line	:	DIVISION OF PHARMACY - CHILDREN'S NATIONAL HOSPITAL
City	:	WASHINGTON
State	:	DC
Zip	:	20010
Country	:	US
Telephone Number	:	301-572-6275
Fax Number	:

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

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	07/18/2024

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