Provider Demographics
NPI:1821156266
Name:HALLS DRUG CENTER INC
Entity Type:Organization
Organization Name:HALLS DRUG CENTER INC
Other - Org Name:HALLS MOBILITY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:A
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:360-807-8757
Mailing Address - Street 1:505 S TOWER AVE
Mailing Address - Street 2:STE 2
Mailing Address - City:CENTRALIA
Mailing Address - State:WA
Mailing Address - Zip Code:98531-3919
Mailing Address - Country:US
Mailing Address - Phone:360-736-6635
Mailing Address - Fax:360-736-8489
Practice Address - Street 1:1200 KRESKY AVE
Practice Address - Street 2:
Practice Address - City:CENTRALIA
Practice Address - State:WA
Practice Address - Zip Code:98531-3734
Practice Address - Country:US
Practice Address - Phone:360-736-7344
Practice Address - Fax:360-736-2323
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HALLS DRUG CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-05
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA211003611332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment