Provider Demographics
NPI:1811932734
Name:HALL, KATIE HORNBUCKLE (PHARM D)
Entity type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:HORNBUCKLE
Last Name:HALL
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:MISS
Other - First Name:KATIE
Other - Middle Name:LEE
Other - Last Name:HORNBUCKLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARM D
Mailing Address - Street 1:340 E. MEIGHAN BLVD.
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35903
Mailing Address - Country:US
Mailing Address - Phone:256-504-2224
Mailing Address - Fax:
Practice Address - Street 1:340 E MEIGHAN BLVD
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35903-1049
Practice Address - Country:US
Practice Address - Phone:256-547-8928
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH022462183500000X
AL14807183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist