Heather Rogers Bagwell, PHARMD
Individual provider Active NPI Pharmacist · Hattiesburg, MS
NPI 1992074124 · NPPES record last updated Dec 16, 2011
Key facts
- NPI
- 1992074124
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- P11826 (MS)
- Practice address
- 5093 Hardy St
Hattiesburg, MS 39402-1336 - Phone
- (601) 579-6698
- NPI assigned
- Dec 16, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
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
| License | State | Type | Specialty |
|---|---|---|---|
| P11826 | MS | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | P11826 | MS | Yes |
Addresses
Primary practice location
5093 Hardy St
Hattiesburg, MS 39402-1336
Mailing address
103 Garden LN
Petal, MS 39465-3703
Phone (601) 579-6698
Other providers in Hattiesburg, MS
- Latisha Baber
- Kirona Bacot
- Justin Thomas Badon
- Sophia Badon
- Horace H Baggett
- Julie Baham Lacour
- Ghazwan Imad Bahro
- Alexis Bailey
- Boston Bailey
- Brian Alan Bailey
All providers in Hattiesburg, MS · Pharmacist in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 16, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.