MEDICARE: GLORIA GRIGG HALL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	9486	AL

General Provider Information

NPI Number	:	1104355759
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GLORIA GRIGG HALL

Provider Business Mailing Address
First Line	:	104 INGRAM DR
Second Line	:
City	:	TROY
State	:	AL
Zip	:	36079-2984
Country	:	US
Telephone Number	:	334-372-1171
Fax Number	:

Provider Business Practice Location Address
First Line	:	1420 HIGHWAY 231 S
Second Line	:
City	:	TROY
State	:	AL
Zip	:	36081-2504
Country	:	US
Telephone Number	:	334-566-8009
Fax Number	:	334-566-5739

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2017
Last Update Date	:	06/07/2017

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Directions to “ GLORIA GRIGG HALL ” Practice Location

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