Provider Demographics
NPI:1922028380
Name:JOHN D HALL
Entity Type:Organization
Organization Name:JOHN D HALL
Other - Org Name:HALL'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PIC
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:979-798-2111
Mailing Address - Street 1:PO BOX 4043
Mailing Address - Street 2:
Mailing Address - City:BRAZORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77422-4043
Mailing Address - Country:US
Mailing Address - Phone:979-798-2111
Mailing Address - Fax:979-798-2115
Practice Address - Street 1:102 A EAST SAN BERNARD
Practice Address - Street 2:
Practice Address - City:BRAZORIA
Practice Address - State:TX
Practice Address - Zip Code:77422-5611
Practice Address - Country:US
Practice Address - Phone:979-798-2111
Practice Address - Fax:979-798-2111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX209003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX145078Medicaid
TX4519382OtherNABP NUMBER
TX4519382OtherNABP NUMBER
TXBT7266162OtherDEA #