Healthcare Provider Details

I. General information

NPI: 1548525884
Provider Name (Legal Business Name): AMANDA GERDTS HOLLAR PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2012
Last Update Date: 12/22/2022
Certification Date: 12/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2816 ERWIN RD STE 105
DURHAM NC
27705-4589
US

IV. Provider business mailing address

2816 ERWIN RD STE 105
DURHAM NC
27705-4589
US

V. Phone/Fax

Practice location:
  • Phone: 919-682-9271
  • Fax: 919-933-3954
Mailing address:
  • Phone: 919-282-5553
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number22750
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: