Provider Demographics
NPI:1538356910
Name:HALBROOK, BEAL MARL (PHARM D)
Entity type:Individual
Prefix:DR
First Name:BEAL
Middle Name:MARL
Last Name:HALBROOK
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2007 GILLIONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31707-3139
Mailing Address - Country:US
Mailing Address - Phone:229-436-2985
Mailing Address - Fax:229-436-2987
Practice Address - Street 1:2007 GILLIONVILLE RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-3139
Practice Address - Country:US
Practice Address - Phone:229-436-2985
Practice Address - Fax:229-436-2987
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-28
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA017598183500000X, 1835N0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835N0905XPharmacy Service ProvidersPharmacistNuclear