Christopher Allan Hagen, PHARMD

Key facts

NPI

1508950783

Entity type

Individual (NPI type 1)

Primary specialty

Pharmacotherapy Pharmacist 1835P1200X

License

1169898 (MN)

Practice address

50 Centracare Drive
Centracare Health Long Prairie
Long Prairie, MN 56347-2100

Phone

(320) 732-2141

Fax

(320) 732-6913

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Doctor of Pharmacy

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 8, 2018.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518048000000",
    "number": "1508950783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 CENTRACARE DRIVE",
            "address_2": "CENTRACARE HEALTH LONG PRAIRIE",
            "city": "LONG PRAIRIE",
            "state": "MN",
            "postal_code": "563472100",
            "telephone_number": "320-732-2141",
            "fax_number": "320-732-6913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 CENTRACARE DRIVE",
            "address_2": "CENTRACARE HEALTH LONG PRAIRIE",
            "city": "LONG PRAIRIE",
            "state": "MN",
            "postal_code": "563472100",
            "telephone_number": "320-732-2141",
            "fax_number": "320-732-6913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGEN",
        "first_name": "CHRISTOPHER",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2018-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "MN",
            "license": "1169898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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