MEDICARE: DR. CYNTHIA HALL PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	RPH017968	GA
2	183500000X	Pharmacist	PS 28535	FL

General Provider Information

NPI Number	:	1073850020
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CYNTHIA HALL PHARM.D.

Provider Business Mailing Address
First Line	:	2158 HIGHWAY 20 W
Second Line	:
City	:	MCDONOUGH
State	:	GA
Zip	:	30253-7205
Country	:	US
Telephone Number	:	770-898-6731
Fax Number	:

Provider Business Practice Location Address
First Line	:	2158 HIGHWAY 20 W
Second Line	:
City	:	MCDONOUGH
State	:	GA
Zip	:	30253-7205
Country	:	US
Telephone Number	:	770-898-6731
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/10/2013
Last Update Date	:	01/10/2013

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