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General NPI Number Information
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NPI Number | 1053619197
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Entity Type | Individual
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Provider Name | ELIZABETH BUCKLEY HALL BS PHARM
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Gender | Female
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Dates
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Enumeration Date | 03/13/2011
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Last Update Date | 06/08/2015
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Provider Practice Location Address
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Address Line | 11855 JONES BRIDGE RD
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City | ALPHARETTA
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State | GA
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Zip | 30005-5042
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Country | US
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Telephone | 770-521-1292
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Fax | 770-521-9024
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Provider Business Mailing Address
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Address Line | 315 HOPE DR
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City | SUWANEE
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State | GA
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Zip | 30024-1415
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Country | US
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Telephone | 770-307-8200
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 019910
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License Number State | GA
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