MEDICARE: DR. MATTHEW HALL PHARMD

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	2015027703	MO
2	183500000X	Pharmacist	051292761	IL

General Provider Information

NPI Number	:	1801252606
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW HALL PHARMD

Provider Business Mailing Address
First Line	:	7010 PERSHING AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63130-4318
Country	:	US
Telephone Number	:	314-802-7012
Fax Number	:	314-312-6995

Provider Business Practice Location Address
First Line	:	7010 PERSHING AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63130-4318
Country	:	US
Telephone Number	:	314-802-7012
Fax Number	:	314-312-6995

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

Provider Enumeration Date	:	01/08/2016
Last Update Date	:	01/08/2016

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Directions to “ DR. MATTHEW HALL PHARMD” Practice Location

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