MEDICARE: BRETT SAMUEL HALL PHARMD

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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	026667	GA

General Provider Information

NPI Number	:	1790221711
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRETT SAMUEL HALL PHARMD

Provider Business Mailing Address
First Line	:	1700 MONROE DR NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30324-5033
Country	:	US
Telephone Number	:	404-872-0785
Fax Number	:	404-873-7063

Provider Business Practice Location Address
First Line	:	1700 MONROE DR NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30324-5033
Country	:	US
Telephone Number	:	404-872-0785
Fax Number	:	404-873-7063

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

Provider Enumeration Date	:	01/13/2017
Last Update Date	:	05/22/2026

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