Provider Demographics
NPI:1568951523
Name:HALL, MICHELLE LEE (RPH)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LEE
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 1:219 OAKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:WEST PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45663-8908
Mailing Address - Country:US
Mailing Address - Phone:740-935-0100
Mailing Address - Fax:
Practice Address - Street 1:901 WASHINGTON ST RM 135
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-3944
Practice Address - Country:US
Practice Address - Phone:740-370-0759
Practice Address - Fax:740-370-6749
Is Sole Proprietor?:No
Enumeration Date:2018-05-05
Last Update Date:2018-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY011449183500000X
OH03319972183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist