MEDICARE: ROBERT HALL

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	13754	NC

General Provider Information

NPI Number	:	1336447085
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT HALL

Provider Business Mailing Address
First Line	:	113 LAKE POINT DR
Second Line	:
City	:	CHERRYVILLE
State	:	NC
Zip	:	28021-9374
Country	:	US
Telephone Number	:	704-484-1970
Fax Number	:

Provider Business Practice Location Address
First Line	:	1170 E MARION ST
Second Line	:
City	:	SHELBY
State	:	NC
Zip	:	28150-4845
Country	:	US
Telephone Number	:	704-487-7221
Fax Number	:

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

Provider Enumeration Date	:	03/04/2011
Last Update Date	:	03/04/2011

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Directions to “ ROBERT HALL ” Practice Location

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