Provider Demographics
NPI:1831970920
Name:HALL, ANGELA KAYE (RPH)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:KAYE
Last Name:HALL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:654 PARLIAMENT CT
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-5862
Mailing Address - Country:US
Mailing Address - Phone:970-593-2121
Mailing Address - Fax:
Practice Address - Street 1:15000 W 6TH AVE STE 300
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-5047
Practice Address - Country:US
Practice Address - Phone:970-593-2121
Practice Address - Fax:954-660-5571
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-13
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV14753183500000X
WY3904183500000X
CO14102183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist