Provider Demographics
NPI:1760578421
Name:GARRIGAN, JUDITH HAYDEN (RPH)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:HAYDEN
Last Name:GARRIGAN
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 1:15 MASSACHUSETTS AVENUE
Mailing Address - Street 2:
Mailing Address - City:WALPOLE
Mailing Address - State:MA
Mailing Address - Zip Code:02081
Mailing Address - Country:US
Mailing Address - Phone:508-668-7835
Mailing Address - Fax:
Practice Address - Street 1:150 SOUTH HUNTINGTON AVE
Practice Address - Street 2:
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-4893
Practice Address - Country:US
Practice Address - Phone:857-364-5367
Practice Address - Fax:857-364-4428
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA16555183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist