Healthcare Provider Details

I. General information

NPI: 1861761595
Provider Name (Legal Business Name): HOLLY E HOFFMAN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2011
Last Update Date: 12/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 JOHNSTON ST
LAFAYETTE LA
70503-3242
US

IV. Provider business mailing address

8737 HIGHWAY 23
BELLE CHASSE LA
70037-2232
US

V. Phone/Fax

Practice location:
  • Phone: 337-232-9317
  • Fax:
Mailing address:
  • Phone: 936-556-0675
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number019513
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number50524
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: