Individual
MRS. DEBRA HAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
4019 FAIRDALE RD, PHILADELPHIA, PA 19154-3609
(215) 632-2828
Mailing address
3721 VADER RD, PHILADELPHIA, PA 19154-3030
(215) 501-8301
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP043130L
PA
Other
Enumeration date
06/24/2010
Last updated
06/24/2010
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