Drew Holtz, RPH
Individual provider Active NPI Pharmacist · Republic, MO
NPI 1346522265 · NPPES record last updated Sep 16, 2011
Key facts
- NPI
- 1346522265
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 42205 (MO)
- Practice address
- 1050 US Highway 60 E
Republic, MO 65738-1569 - Phone
- (417) 732-8246
- Fax
- (417) 732-8621
- NPI assigned
- Sep 16, 2011
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 42205 | MO | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 42205 | MO | Yes |
Addresses
Primary practice location
1050 US Highway 60 E
Republic, MO 65738-1569
Mailing address
5445 W Dulin LN
Brookline, MO 65619-9812
Phone (417) 732-8246
Other providers in Republic, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 16, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.