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General NPI Number Information
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NPI Number | 1043427487
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Entity Type | Organization
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Legal Business Name | HALS COMPOUNDING PHARMACY, INC.
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3825 32ND ST
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City | SAN DIEGO
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State | CA
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Zip | 92104-3704
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Country | US
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Telephone | 619-282-0223
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Fax | 619-282-1017
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Provider Business Mailing Address
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Address Line | 3825 32ND ST
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City | SAN DIEGO
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State | CA
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Zip | 92104-3704
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Country | US
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Telephone | 619-282-0223
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Fax | 619-282-1017
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. HAROLD KELLER
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Credential | PHARMD
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Telephone | 619-282-0223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PHY 22438
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License Number State | CA
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