Individual
MRS. TRACEY LUANNE HAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM.D
Contact information
Practice address
650 E INDIAN SCHOOL RD, C/O CARL T HAYDEN VA MEDICAL CENTER, PHOENIX, AZ 85012-1839
(602) 277-5551
(602) 222-2679
Mailing address
669 E BRIDLE WAY, GILBERT, AZ 85296-5950
(480) 705-0359
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
18243
IA
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
10772
AZ
Other
Enumeration date
08/17/2006
Last updated
03/19/2020
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