Provider Demographics
NPI:1730529173
Name:HAGMEIER, LISA ANN (RPH)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:ANN
Last Name:HAGMEIER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 N MONTANA AVE
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-3885
Mailing Address - Country:US
Mailing Address - Phone:406-442-9800
Mailing Address - Fax:
Practice Address - Street 1:603 N MONTANA AVE
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-3885
Practice Address - Country:US
Practice Address - Phone:406-442-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-30
Last Update Date:2013-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT5574183500000X
WA00011210183500000X
IDP-4406183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist