Provider Demographics
NPI:1134729304
Name:RIALS, HAILEY (PHARMD)
Entity type:Individual
Prefix:
First Name:HAILEY
Middle Name:
Last Name:RIALS
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 1:1380 GA HIGHWAY 292
Mailing Address - Street 2:
Mailing Address - City:LYONS
Mailing Address - State:GA
Mailing Address - Zip Code:30436-2546
Mailing Address - Country:US
Mailing Address - Phone:912-655-2234
Mailing Address - Fax:
Practice Address - Street 1:150 ALTAMA CONNECTOR
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31525-2203
Practice Address - Country:US
Practice Address - Phone:912-261-0553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH031735183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist