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NPI Code Detail

MEDICARE: AMELIA MARIE HOLLOWAY PHARMD

MEDICARE: AMELIA MARIE HOLLOWAY PHARMD
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
1183500000XPharmacist26020045AIN

General Provider Information

NPI Number : 1861575565
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMELIA MARIE HOLLOWAY PHARMD
Provider Business Mailing Address
First Line : 227 NW PASSAGE TRL
Second Line :
City : FORT WAYNE
State : IN
Zip : 46825-2083
Country : US
Telephone Number : 260-497-7309
Fax Number :
Provider Business Practice Location Address
First Line : 2121 LAKE AVE
Second Line :
City : FORT WAYNE
State : IN
Zip : 46805-5100
Country : US
Telephone Number : 260-426-5431
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2006
Last Update Date : 05/06/2026

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