Provider Demographics
NPI:1710254966
Name:HALL, CELESTE RENEE (RPH)
Entity Type:Individual
Prefix:
First Name:CELESTE
Middle Name:RENEE
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 1:3165 COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:CONNELLSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15425-9747
Mailing Address - Country:US
Mailing Address - Phone:724-970-1654
Mailing Address - Fax:
Practice Address - Street 1:1000 LINCOLN PL
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-1251
Practice Address - Country:US
Practice Address - Phone:724-850-8191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-16
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP041848L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist