Provider Demographics
NPI:1275653842
Name:HALE, KENT ALAN (RPH)
Entity Type:Individual
Prefix:MR
First Name:KENT
Middle Name:ALAN
Last Name:HALE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 E CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:AL
Mailing Address - Zip Code:36748-1302
Mailing Address - Country:US
Mailing Address - Phone:334-295-1912
Mailing Address - Fax:
Practice Address - Street 1:1952 W DALLAS AVE
Practice Address - Street 2:
Practice Address - City:SELMA
Practice Address - State:AL
Practice Address - Zip Code:36701-7027
Practice Address - Country:US
Practice Address - Phone:334-872-7211
Practice Address - Fax:334-872-7016
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11978183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist