Healthcare Provider Details

I. General information

NPI: 1952952152
Provider Name (Legal Business Name): MEREDITH GRACE HOLLMAN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2019
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 W HOLT AVE
MILWAUKEE WI
53207-3200
US

IV. Provider business mailing address

250 W HOLT AVE
MILWAUKEE WI
53207-3200
US

V. Phone/Fax

Practice location:
  • Phone: 414-769-8990
  • Fax:
Mailing address:
  • Phone: 414-769-8990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number149178
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number22687-40
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302416803
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: