Provider Demographics
NPI:1891062956
Name:HAILE, LULA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LULA
Middle Name:
Last Name:HAILE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3715 MECHANICSVILLE TPKE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-1331
Mailing Address - Country:US
Mailing Address - Phone:804-329-1555
Mailing Address - Fax:804-329-2763
Practice Address - Street 1:3715 MECHANICSVILLE TPKE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223-1331
Practice Address - Country:US
Practice Address - Phone:804-329-1555
Practice Address - Fax:804-329-2763
Is Sole Proprietor?:No
Enumeration Date:2011-11-17
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202207288183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist