Provider Demographics
NPI:1164122503
Name:HALL, HARRISON HUNTER (CPHT)
Entity Type:Individual
Prefix:
First Name:HARRISON
Middle Name:HUNTER
Last Name:HALL
Suffix:
Gender:M
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 CLEARWATER LN
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-4700
Mailing Address - Country:US
Mailing Address - Phone:757-692-8485
Mailing Address - Fax:
Practice Address - Street 1:1605 CLEARWATER LN
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-4700
Practice Address - Country:US
Practice Address - Phone:757-692-8485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0230038982183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician