Provider Demographics
NPI:1457084485
Name:HOLLIS, BRETT ADAM (PHARMD)
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:ADAM
Last Name:HOLLIS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:879 HIGHWAY 78
Mailing Address - Street 2:
Mailing Address - City:SUMITON
Mailing Address - State:AL
Mailing Address - Zip Code:35148-3416
Mailing Address - Country:US
Mailing Address - Phone:205-648-8420
Mailing Address - Fax:
Practice Address - Street 1:879 HIGHWAY 78
Practice Address - Street 2:
Practice Address - City:SUMITON
Practice Address - State:AL
Practice Address - Zip Code:35148-3416
Practice Address - Country:US
Practice Address - Phone:205-648-8420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-07
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL22540183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist