Provider Demographics
NPI:1760761944
Name:AGU, HARRIETTE C (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:HARRIETTE
Middle Name:C
Last Name:AGU
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:367 RUSSELL ST
Mailing Address - Street 2:T-1839
Mailing Address - City:HADLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01035-9456
Mailing Address - Country:US
Mailing Address - Phone:617-943-0118
Mailing Address - Fax:
Practice Address - Street 1:367 RUSSELL ST
Practice Address - Street 2:T-1839
Practice Address - City:HADLEY
Practice Address - State:MA
Practice Address - Zip Code:01035-9456
Practice Address - Country:US
Practice Address - Phone:617-943-0118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-05
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH233686183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist