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General NPI Number Information
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NPI Number | 1053901728
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Entity Type | Individual
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Provider Name | HOLLY J. A. STRATTARD RPH
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Gender | Female
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Dates
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Enumeration Date | 01/26/2021
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Last Update Date | 01/26/2021
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Provider Practice Location Address
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Address Line | 310 CENTER RD
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City | GRAY
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State | ME
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Zip | 04039-5447
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Country | US
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Telephone | 207-657-6122
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 783
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City | GRAY
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State | ME
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Zip | 04039-0783
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Country | US
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Telephone | 207-657-6122
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PR4983
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License Number State | ME
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