Provider Demographics
NPI:1811476435
Name:HAGAN, CHRISTOPHER RICHARD (PHARMD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:RICHARD
Last Name:HAGAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 JAY ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-1160
Mailing Address - Country:US
Mailing Address - Phone:678-722-1098
Mailing Address - Fax:
Practice Address - Street 1:301 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29672-9491
Practice Address - Country:US
Practice Address - Phone:864-882-7397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-14
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC37867183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist