Provider Demographics
NPI:1972625242
Name:HALE, GARY ARVEL (RPH)
Entity type:Individual
Prefix:MR
First Name:GARY
Middle Name:ARVEL
Last Name:HALE
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 1:345 E 100 S
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84014-2367
Mailing Address - Country:US
Mailing Address - Phone:801-296-1549
Mailing Address - Fax:801-292-9390
Practice Address - Street 1:190 S 500 W
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-8729
Practice Address - Country:US
Practice Address - Phone:801-295-6900
Practice Address - Fax:801-292-9390
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT97-289960-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist