Provider Demographics
NPI:1710158589
Name:HALL'S PHARMACY
Entity Type:Organization
Organization Name:HALL'S PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE-MGR
Authorized Official - Prefix:MRS
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:O
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-877-3677
Mailing Address - Street 1:708 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-2221
Mailing Address - Country:US
Mailing Address - Phone:817-877-3677
Mailing Address - Fax:817-877-9981
Practice Address - Street 1:708 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2221
Practice Address - Country:US
Practice Address - Phone:817-877-3677
Practice Address - Fax:817-877-9981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10169333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX505771Medicare PIN