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General NPI Number Information
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NPI Number | 1568067858
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Entity Type | Individual
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Provider Name | CORY MICHAEL HALL
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Gender | Male
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Dates
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Enumeration Date | 12/03/2020
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Last Update Date | 12/03/2020
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Provider Practice Location Address
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Address Line | 33 E MARKET ST
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City | LEWISTOWN
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State | PA
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Zip | 17044-2124
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Country | US
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Telephone | 717-248-0921
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Fax |
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Provider Business Mailing Address
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Address Line | 87 RAGER LN
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City | MC CLURE
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State | PA
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Zip | 17841-9215
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Country | US
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Telephone | 570-492-3789
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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 | RP446737
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License Number State | PA
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