Provider Demographics
NPI:1306237888
Name:HALL, JANELLE (CST, CPHT)
Entity type:Individual
Prefix:
First Name:JANELLE
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:CST, CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5707 JANNEYS MILL CIR
Mailing Address - Street 2:
Mailing Address - City:HAYMARKET
Mailing Address - State:VA
Mailing Address - Zip Code:20169-6197
Mailing Address - Country:US
Mailing Address - Phone:703-229-3209
Mailing Address - Fax:
Practice Address - Street 1:13301 GATEWAY CENTER DR
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-2984
Practice Address - Country:US
Practice Address - Phone:571-261-5061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-05
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0230022923183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician