Healthcare Provider Details

I. General information

NPI: 1770351330
Provider Name (Legal Business Name): MADELYN ELIZABETH HALL PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2023
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2315 STOCKTON BLVD
SACRAMENTO CA
95817-2201
US

IV. Provider business mailing address

2239 CREEKSIDE BND
SAN ANTONIO TX
78259-3318
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-3305
  • Fax:
Mailing address:
  • Phone: 210-606-1104
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number92676
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: