MEDICARE: HOLLI M ANTHONY RPH

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
1	183500000X	Pharmacist	13450	AL

General Provider Information

NPI Number	:	1821466939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOLLI M ANTHONY RPH

Provider Business Mailing Address
First Line	:	293 WINDSONG LOOP
Second Line	:
City	:	WETUMPKA
State	:	AL
Zip	:	36093-3067
Country	:	US
Telephone Number	:	334-546-0382
Fax Number	:

Provider Business Practice Location Address
First Line	:	355 INDUSTRIAL PARK BLVD
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36117-5550
Country	:	US
Telephone Number	:	334-244-0200
Fax Number	:	888-256-8771

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/04/2015
Last Update Date	:	09/29/2020

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