Provider Demographics
NPI:1346789468
Name:HODOLY, BRANDT (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:BRANDT
Middle Name:
Last Name:HODOLY
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6528 S 118TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-3577
Mailing Address - Country:US
Mailing Address - Phone:888-895-7133
Mailing Address - Fax:800-878-2224
Practice Address - Street 1:6528 S 118TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-3577
Practice Address - Country:US
Practice Address - Phone:888-895-7133
Practice Address - Fax:800-878-2224
Is Sole Proprietor?:No
Enumeration Date:2017-02-22
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE11543183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist