MEDICARE: EDWARD YAW HAGAN PHARMD, 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	RP459324	PA

General Provider Information

NPI Number	:	1780569822
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDWARD YAW HAGAN PHARMD, RPH

Provider Business Mailing Address
First Line	:	2100 N HANCOCK ST APT 2
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19122-1652
Country	:	US
Telephone Number	:	770-366-7150
Fax Number	:

Provider Business Practice Location Address
First Line	:	3780 MAIN ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19127-2108
Country	:	US
Telephone Number	:	215-508-3607
Fax Number	:

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

Provider Enumeration Date	:	08/07/2025
Last Update Date	:	08/07/2025

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