Provider Demographics
NPI:1235984113
Name:HAGGARD, RACHEL
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:HAGGARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:651 CORPORATE CIR STE 203A
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-5653
Mailing Address - Country:US
Mailing Address - Phone:800-525-9473
Mailing Address - Fax:
Practice Address - Street 1:231 VIOLET ST
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-6722
Practice Address - Country:US
Practice Address - Phone:800-525-9473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-23
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN34498183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist