Lisa Lynn Hall
Individual provider Active NPI Pharmacist · Baxley, GA
NPI 1972017242 · NPPES record last updated Aug 19, 2020
Key facts
- NPI
- 1972017242
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RPH019373 (GA)
- Practice address
- 117 N Main St
Baxley, GA 31513-0070 - Phone
- (912) 367-8404
- Fax
- (912) 367-8405
- NPI assigned
- Nov 25, 2017
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH019373 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Abundant Life Pharmacy & Health Foods Inc | Current |
Accepting new patients |
Locations
117 N Main St
Baxley, GA 31513
Phone (912) 367-8404
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH019373 | GA | Yes |
Addresses
Primary practice location
117 N Main St
Baxley, GA 31513-0070
Mailing address
117 N Main St
Baxley, GA 31513-0070
Phone (912) 367-8404
Other providers in Baxley, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 19, 2020. 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.