Provider Demographics
NPI:1104129402
Name:HALL, JAMES SCOTT (RPH)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:SCOTT
Last Name:HALL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5237 PROVIDENCE RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-4201
Mailing Address - Country:US
Mailing Address - Phone:757-495-3106
Mailing Address - Fax:757-495-4248
Practice Address - Street 1:5237 PROVIDENCE RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-4201
Practice Address - Country:US
Practice Address - Phone:757-495-3106
Practice Address - Fax:757-495-4248
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-08
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202007787183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist