Provider Demographics
NPI:1265861686
Name:HOLLOWAY, JOSEPH MICHAEL (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:MICHAEL
Last Name:HOLLOWAY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:835 ODUM RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GARDENDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35071-4623
Mailing Address - Country:US
Mailing Address - Phone:205-631-8989
Mailing Address - Fax:205-631-8990
Practice Address - Street 1:835 ODUM RD
Practice Address - Street 2:SUITE 101
Practice Address - City:GARDENDALE
Practice Address - State:AL
Practice Address - Zip Code:35071-4623
Practice Address - Country:US
Practice Address - Phone:205-631-8989
Practice Address - Fax:205-631-8990
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-06
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11146183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist