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Organization
ROBERT L HAGEN
Active
Organization
ROBERT L HAGEN
Active
Other names
HAGENS FAMILY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT HAGEN RPH (OWNER)
(217) 728-7388
Entity
Organization
Contact information
Practice address
8 E HARRISON ST, SULLIVAN, IL 61951-1905
(217) 728-7388
(217) 728-8046
Mailing address
8 E HARRISON ST, SULLIVAN, IL 61951-1905
(217) 728-7388
(217) 728-8046
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
054007624
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1445320
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/20/2006
Last updated
12/14/2011
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