Eldon Ray Hall, RPH
Individual provider Active NPI Pharmacist · Warrensburg, NY
NPI 1558549865 · NPPES record last updated Feb 8, 2008
Key facts
- NPI
- 1558549865
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 29516 (NY)
- Practice address
- 3864 Main St
Warrensburg, NY 12885-1432 - Phone
- (518) 623-5291
- NPI assigned
- Feb 8, 2008
- 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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29516 | NY | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 29516 | NY | Yes |
Addresses
Primary practice location
3864 Main St
Warrensburg, NY 12885-1432
Mailing address
87 Lake Ave
Warrensburg, NY 12885-1024
Phone (518) 623-2948
Other providers in Warrensburg, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 8, 2008. 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.