Provider Demographics
NPI:1972863736
Name:MUHANNA, HALA (PHARMD)
Entity Type:Individual
Prefix:
First Name:HALA
Middle Name:
Last Name:MUHANNA
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 1:3070 TOLBERT DR
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-2508
Mailing Address - Country:US
Mailing Address - Phone:404-313-3756
Mailing Address - Fax:
Practice Address - Street 1:2580 WINDER HWY
Practice Address - Street 2:
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019-1328
Practice Address - Country:US
Practice Address - Phone:770-682-0213
Practice Address - Fax:770-682-4371
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-25
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH026447183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist