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NPI Code Detail

MEDICARE: BEVERLY ANN HOLLAND

MEDICARE: BEVERLY ANN HOLLAND
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist5302032454MI

General Provider Information

NPI Number : 1164535258
Entity Type Code : Individual
Provider Name (Legal Business Name) : BEVERLY ANN HOLLAND
Provider Business Mailing Address
First Line : 406 E ELM ST
Second Line :
City : CARSON CITY
State : MI
Zip : 48811-9693
Country : US
Telephone Number : 989-584-3971
Fax Number :
Provider Business Practice Location Address
First Line : 406 E ELM ST
Second Line :
City : CARSON CITY
State : MI
Zip : 48811-9693
Country : US
Telephone Number : 989-584-3971
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2006
Last Update Date : 07/08/2007

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Directions to “ BEVERLY ANN HOLLAND ” Practice Location

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