MEDICARE: ALAN LAMAR HALL RPH

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	337520-1701	UT

General Provider Information

NPI Number	:	1487984977
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALAN LAMAR HALL RPH

Provider Business Mailing Address
First Line	:	7321 BALMER ST BLDG 570
Second Line	:
City	:	HILL AIR FORCE BASE
State	:	UT
Zip	:	84056-5012
Country	:	US
Telephone Number	:	801-777-0419
Fax Number	:	801-586-9890

Provider Business Practice Location Address
First Line	:	7321 BALMER ST BLDG 570
Second Line	:
City	:	HILL AIR FORCE BASE
State	:	UT
Zip	:	84056-5012
Country	:	US
Telephone Number	:	801-777-0419
Fax Number	:	801-586-9890

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

Provider Enumeration Date	:	01/05/2010
Last Update Date	:	01/05/2010

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