Provider Demographics
NPI:1538280995
Name:HOLZBACH, GEORGE B JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:B
Last Name:HOLZBACH
Suffix:JR
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 1:13616 WINTERBERRY RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-4946
Mailing Address - Country:US
Mailing Address - Phone:804-744-2427
Mailing Address - Fax:
Practice Address - Street 1:500 N HARRISON ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23220-3008
Practice Address - Country:US
Practice Address - Phone:804-358-4999
Practice Address - Fax:804-359-6854
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202003873183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist