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Individual

GERALD H FAGEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
2401 VALLEY DR, VALPARAISO, IN 46383-2520
(219) 413-5100
Mailing address
42 CASTLETON RD, VALPARAISO, IN 46385-8846

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26016923A
IN

Other

Enumeration date
08/15/2018
Last updated
06/30/2023
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