Provider Demographics
NPI:1750667119
Name:HAGEMEYER, KAREN SUE (RPH)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:SUE
Last Name:HAGEMEYER
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 1:13632 CLOVERDALE RD
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402-9547
Mailing Address - Country:US
Mailing Address - Phone:419-308-9900
Mailing Address - Fax:
Practice Address - Street 1:13632 CLOVERDALE RD
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:OH
Practice Address - Zip Code:43402-9547
Practice Address - Country:US
Practice Address - Phone:419-308-9900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-31
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-200871835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric