=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841177599
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HALEY RAE HALL PHARMD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/16/2025
-----------------------------------------------------
Last Update Date | 09/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 34800 BOB WILSON DR
-----------------------------------------------------
City | SAN DIEGO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92134-1098
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 619-532-6400
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3166 S LAUREL FORK RD
-----------------------------------------------------
City | LAUREL SPRINGS
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28644-8622
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-572-2615
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 33857
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------