MEDICARE: MS. MINA CAROL HALL RPH

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	8459	TN

General Provider Information

NPI Number	:	1538248109
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MINA CAROL HALL RPH

Provider Business Mailing Address
First Line	:	3360 N WATKINS ST STE 101-102
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38127-6405
Country	:	US
Telephone Number	:	901-930-0999
Fax Number	:	901-324-1051

Provider Business Practice Location Address
First Line	:	3360 N WATKINS ST
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38127-6405
Country	:	US
Telephone Number	:	901-930-0999
Fax Number	:	901-324-1051

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

Provider Enumeration Date	:	11/03/2006
Last Update Date	:	05/19/2024

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