Active NPI
John Neal Holley, RPH.
- Pharmacist
- Enterprise, AL
National Provider Identifier
1508343336
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 12517
- Practice address
- 612 N Main St Ste a
Enterprise, AL 36330-1775 - Phone
- (334) 393-0086
- Fax
- (334) 393-0206
- NPI assigned
- Jul 24, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 12517 | AL | Primary |
Addresses
Primary practice location
612 N Main St Ste a
Enterprise, AL 36330-1775
Mailing address
612 N Main St Ste a
Enterprise, AL 36330-1775
Phone (334) 393-0086
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 183049 | Medicaid | AL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12517 | AL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeast Pharmaceuticals, Inc | Current | Accepting new patients | |
| Southeast Pharmaceuticals, Inc. | Current | Accepting new patients | |
| Holley Pharmacy Inc | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Durable Medical Equipment & Medical Supplies
- Elba, AL
- NPI 1427167477
-
- Oxygen Equipment & Supplies (DME)
- Elba, AL
- NPI 1518054816
-
- Community/Retail Pharmacy
- Enterprise, AL
- NPI 1568822021
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1532390400000",
"number": "1508343336",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "612 N MAIN ST STE A",
"city": "ENTERPRISE",
"state": "AL",
"postal_code": "363301775",
"telephone_number": "334-393-0086",
"fax_number": "334-393-0206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "612 N MAIN ST STE A",
"city": "ENTERPRISE",
"state": "AL",
"postal_code": "363301775",
"telephone_number": "334-393-0086",
"fax_number": "334-393-0206"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLEY",
"first_name": "JOHN",
"middle_name": "NEAL",
"name_prefix": "Mr.",
"credential": "RPH.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-07-24",
"last_updated": "2018-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AL",
"license": "12517",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "183049",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Enterprise, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.