Provider Demographics
NPI:1073676664
Name:HAGERICH ENTERPRISES, LLC
Entity Type:Organization
Organization Name:HAGERICH ENTERPRISES, LLC
Other - Org Name:TRIANGLE SPINE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:HAGERICH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:919-957-3600
Mailing Address - Street 1:7854 ALEXANDER PROMENADE PL
Mailing Address - Street 2:SUITE 110
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-7833
Mailing Address - Country:US
Mailing Address - Phone:919-957-3600
Mailing Address - Fax:919-957-3800
Practice Address - Street 1:7854 ALEXANDER PROMENADE PL
Practice Address - Street 2:SUITE 110
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-7833
Practice Address - Country:US
Practice Address - Phone:919-957-3600
Practice Address - Fax:919-957-3800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2007-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3340111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty