Provider Demographics
NPI:1346077906
Name:HALL, CHARLES OAXACA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:OAXACA
Last Name:HALL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2558 E SIMPSON AVE
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84109-1339
Mailing Address - Country:US
Mailing Address - Phone:801-604-8736
Mailing Address - Fax:
Practice Address - Street 1:1890 S 3850 W STE 220
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84104-4939
Practice Address - Country:US
Practice Address - Phone:385-549-1121
Practice Address - Fax:855-571-3472
Is Sole Proprietor?:No
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT376949-17011835P1200X, 1835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy