Healthcare Provider Details

I. General information

NPI: 1336687888
Provider Name (Legal Business Name): JOSHUA HOLLAND PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2017
Last Update Date: 02/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1423 N JEFFERSON AVE
SPRINGFIELD MO
65802-1917
US

IV. Provider business mailing address

4378 E SHERWOOD ST
SPRINGFIELD MO
65802-2382
US

V. Phone/Fax

Practice location:
  • Phone: 417-269-3418
  • Fax:
Mailing address:
  • Phone: 701-388-0160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number2008020970
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: