Individual provider Active NPI

Douglas Albert Hollie III, RPH

  • Pharmacist
  • Minneapolis, MN
National Provider Identifier
1891965166
Registry record updated Mar 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
113277 Issued in MN
Practice address
One Veterans Drive
Veterans Affairs Medical Center (119)
Minneapolis, MN 55417-2309
Phone
(612) 725-2040
Fax
(612) 727-5671
NPI assigned
Mar 3, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 113277 MN Primary

Addresses

Primary practice location

One Veterans Drive
Veterans Affairs Medical Center (119)
Minneapolis, MN 55417-2309

Mailing address

One Veterans Drive
Veterans Affairs Medical Center (119)
Minneapolis, MN 55417-2309
Phone (612) 725-2040

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

LicenseStateTypeSpecialty
113277MNMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1204502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204502400000",
    "number": "1891965166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE VETERANS DRIVE",
            "address_2": "VETERANS AFFAIRS MEDICAL CENTER (119)",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554172309",
            "telephone_number": "612-725-2040",
            "fax_number": "612-727-5671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE VETERANS DRIVE",
            "address_2": "VETERANS AFFAIRS MEDICAL CENTER (119)",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554172309",
            "telephone_number": "612-725-2040",
            "fax_number": "612-727-5671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLIE",
        "first_name": "DOUGLAS",
        "middle_name": "ALBERT",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-03",
        "last_updated": "2008-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "113277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.