Lee Ann Holland, RPH

Individual provider Active NPI Pharmacist · Pilot Mountain, NC

NPI 1376837229 · NPPES record last updated Jun 7, 2011

Key facts

NPI
1376837229
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
8628 (NC)
Practice address
204 W Main St
Pilot Mountain, NC 27041-9301
Phone
(336) 368-4747
Fax
(336) 368-1091
NPI assigned
Jun 7, 2011
Sex
Female
Sole proprietor
Yes

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

LicenseStateTypeSpecialty
8628NCMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 8628 NC Yes

Addresses

Primary practice location

204 W Main St
Pilot Mountain, NC 27041-9301

Mailing address

204 W Main St
Pilot Mountain, NC 27041-9301
Phone (336) 368-4747

Other identifiers

IdentifierTypeStateIssuer
0865345MedicaidNC

Other providers in Pilot Mountain, NC

All providers in Pilot Mountain, NC · Pharmacist in North Carolina

Sources for this page

Verify at the official NPI Registry.