Provider Demographics
NPI:1740307693
Name:HALL, SCOTT (RPH)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:HALL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14041 WALKING STICK WAY
Mailing Address - Street 2:
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136-7858
Mailing Address - Country:US
Mailing Address - Phone:440-846-1808
Mailing Address - Fax:
Practice Address - Street 1:1105 N COURT ST
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-1521
Practice Address - Country:US
Practice Address - Phone:330-722-1808
Practice Address - Fax:330-721-7072
Is Sole Proprietor?:No
Enumeration Date:2007-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03314225183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist