Provider Demographics
NPI:1801079280
Name:HALE, WILLIAM P (RPH)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:P
Last Name:HALE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:68 N BELLWOOD RD
Mailing Address - Street 2:
Mailing Address - City:BETHALTO
Mailing Address - State:IL
Mailing Address - Zip Code:62010-1794
Mailing Address - Country:US
Mailing Address - Phone:618-377-2151
Mailing Address - Fax:618-377-7966
Practice Address - Street 1:68 N BELLWOOD RD
Practice Address - Street 2:
Practice Address - City:BETHALTO
Practice Address - State:IL
Practice Address - Zip Code:62010-1794
Practice Address - Country:US
Practice Address - Phone:618-377-2151
Practice Address - Fax:618-377-7966
Is Sole Proprietor?:No
Enumeration Date:2007-12-09
Last Update Date:2007-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-037878183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist