Provider Demographics
NPI:1144777871
Name:HALL, ROY
Entity Type:Individual
Prefix:
First Name:ROY
Middle Name:
Last Name:HALL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 SNOW ST
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:AL
Mailing Address - Zip Code:36203-1270
Mailing Address - Country:US
Mailing Address - Phone:256-831-7534
Mailing Address - Fax:256-831-4461
Practice Address - Street 1:601 SNOW ST
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:AL
Practice Address - Zip Code:36203-1270
Practice Address - Country:US
Practice Address - Phone:256-831-7534
Practice Address - Fax:256-831-4461
Is Sole Proprietor?:No
Enumeration Date:2016-09-11
Last Update Date:2016-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10555183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist