Provider Demographics
NPI:1568093573
Name:HALL, CHARLOTTE DONNAN (RPH)
Entity Type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:DONNAN
Last Name:HALL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5928 ZEBULON RD
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-2097
Mailing Address - Country:US
Mailing Address - Phone:478-757-4152
Mailing Address - Fax:478-757-9132
Practice Address - Street 1:5928 ZEBULON RD
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-2097
Practice Address - Country:US
Practice Address - Phone:478-757-4152
Practice Address - Fax:478-757-9132
Is Sole Proprietor?:No
Enumeration Date:2020-01-29
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA0189361835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist