Provider Demographics
NPI:1497840474
Name:HOLLIER'S FAMILY PHARMACY, LLC
Entity Type:Organization
Organization Name:HOLLIER'S FAMILY PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:HOLLIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-332-5010
Mailing Address - Street 1:1456 EAST BRIDGE STREET
Mailing Address - Street 2:
Mailing Address - City:BREAUX BRIDGE
Mailing Address - State:LA
Mailing Address - Zip Code:70517
Mailing Address - Country:US
Mailing Address - Phone:337-332-5010
Mailing Address - Fax:337-332-6068
Practice Address - Street 1:1456 EAST BRIDGE STREET
Practice Address - Street 2:
Practice Address - City:BREAUX BRIDGE
Practice Address - State:LA
Practice Address - Zip Code:70517
Practice Address - Country:US
Practice Address - Phone:337-332-5010
Practice Address - Fax:337-332-6068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4981-IR3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1269646Medicaid
1930785OtherNCPDP
LA4636500001Medicare NSC