Healthcare Provider Details

I. General information

NPI: 1124330931
Provider Name (Legal Business Name): HOLLY SOBCZYNSKI PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2010
Last Update Date: 07/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11743 15 MILE RD
STERLING HEIGHTS MI
48312-5103
US

IV. Provider business mailing address

39250 TOWNHALL ST
HARRISON TOWNSHIP MI
48045-5627
US

V. Phone/Fax

Practice location:
  • Phone: 586-979-3100
  • Fax:
Mailing address:
  • Phone: 586-504-2120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302034818
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: