Healthcare Provider Details

I. General information

NPI: 1255011342
Provider Name (Legal Business Name): DANIEL HALL PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2023
Last Update Date: 07/24/2023
Certification Date: 07/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6913 ROSEWOOD RD NE
ALBUQUERQUE NM
87111-1021
US

IV. Provider business mailing address

6913 ROSEWOOD RD NE
ALBUQUERQUE NM
87111-1021
US

V. Phone/Fax

Practice location:
  • Phone: 505-328-3913
  • Fax:
Mailing address:
  • Phone: 505-328-3913
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835E0208X
TaxonomyEmergency Medicine Pharmacist
License NumberRP6813
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: