Provider Demographics
NPI:1255316196
Name:LAGARDE, LORNA IMPERIAL (RPH)
Entity Type:Individual
Prefix:
First Name:LORNA
Middle Name:IMPERIAL
Last Name:LAGARDE
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 1:5801 DEFENSE PENTAGON
Mailing Address - Street 2:DTHC PHARMACY SERVICES
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20310-0001
Mailing Address - Country:US
Mailing Address - Phone:703-692-8694
Mailing Address - Fax:703-692-0899
Practice Address - Street 1:5801 DEFENSE PENTAGON
Practice Address - Street 2:DTHC PHARMACY SERVICES DTMC PENTAGON
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20310-0001
Practice Address - Country:US
Practice Address - Phone:703-692-8694
Practice Address - Fax:703-692-0899
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPHA23845183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist