Provider Demographics
NPI:1285290221
Name:ALHALABI, HIBA (PHARMACIST)
Entity type:Individual
Prefix:
First Name:HIBA
Middle Name:
Last Name:ALHALABI
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ROYAL HEIGHTS CTR
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62226-5705
Mailing Address - Country:US
Mailing Address - Phone:618-973-3879
Mailing Address - Fax:618-641-9801
Practice Address - Street 1:1 ROYAL HEIGHTS CTR
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62226-5705
Practice Address - Country:US
Practice Address - Phone:618-973-3879
Practice Address - Fax:618-641-9801
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-15
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0512978783336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL600054342Medicaid