Provider Demographics
NPI:1043507445
Name:HOLLAND, RICHARD SAMUEL (RPH, PHD,DPH)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:SAMUEL
Last Name:HOLLAND
Suffix:
Gender:M
Credentials:RPH, PHD,DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 BLANCHETTE DR
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-1878
Mailing Address - Country:US
Mailing Address - Phone:517-420-0013
Mailing Address - Fax:517-203-3017
Practice Address - Street 1:1225 BLANCHETTE DR
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-1878
Practice Address - Country:US
Practice Address - Phone:517-420-0013
Practice Address - Fax:517-203-3017
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-06
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302039170183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist