| NPI | 1609221035 |
|---|---|
| Doing Business As | HAGGEN PHARMACY #3460 |
| Entity Type | Organization |
| Authorized Contact | KATHY GIANNAKOPOULOS Enrollments Manager 208-395-3954 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WA PHAR.CF.60657825) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2016-05-04 |
| Last Update Date | 2020-04-06 |