Provider Demographics
NPI:1043456395
Name:HALL, JULIA KRISTINE (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:KRISTINE
Last Name:HALL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MS
Other - First Name:JULIA
Other - Middle Name:KRISTINE
Other - Last Name:POLZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:15242 NORTH HOLLY RD RITE AID PHARMACY #3497
Mailing Address - Street 2:
Mailing Address - City:HOLLY
Mailing Address - State:MI
Mailing Address - Zip Code:48442
Mailing Address - Country:US
Mailing Address - Phone:248-634-2314
Mailing Address - Fax:248-634-0998
Practice Address - Street 1:15242 NORTH HOLLY RD RITE AID PHARMACY #3497
Practice Address - Street 2:
Practice Address - City:HOLLY
Practice Address - State:MI
Practice Address - Zip Code:48442
Practice Address - Country:US
Practice Address - Phone:248-634-2314
Practice Address - Fax:248-634-0998
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-16
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03228086183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0630446Medicaid
OH0514201502Medicare UPIN