Cody Sean Hall, PHARM.D.
Individual provider Active NPI Pharmacist · East Ridge, TN
NPI 1407264013 · NPPES record last updated Jul 27, 2014
Key facts
- NPI
- 1407264013
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 38491 (TN)
- Practice address
- 4350 Ringgold Rd
East Ridge, TN 37412-2712 - Phone
- (423) 867-1978
- NPI assigned
- Jul 27, 2014
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38491 | TN | MD | Endocrinology, Diabetes & Metabolism Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 38491 | TN | Yes |
Addresses
Primary practice location
4350 Ringgold Rd
East Ridge, TN 37412-2712
Mailing address
4350 Ringgold Rd
East Ridge, TN 37412-2712
Phone (423) 867-1978
Other providers in East Ridge, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 27, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.