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General NPI Number Information
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NPI Number | 1538858394
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Entity Type | Organization
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Legal Business Name | MOSS HOLLAND ENTERPRISES LLC
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Dates
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Enumeration Date | 05/05/2023
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Last Update Date | 12/19/2024
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Provider Practice Location Address
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Address Line | 11621 RAINWOOD RD STE 7
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City | LITTLE ROCK
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State | AR
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Zip | 72212-3947
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Country | US
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Telephone | 501-222-1002
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Fax | 501-222-1807
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Provider Business Mailing Address
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Address Line | PO BOX 21294
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City | LITTLE ROCK
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State | AR
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Zip | 72221-1294
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Country | US
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Telephone | 803-447-1959
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Fax | 501-222-1807
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Authorized Official
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Title or Position | PARTNER
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Name | MARK HOLLAND
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Credential | PHARMD
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Telephone | 803-447-1959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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