Provider Demographics
NPI:1629389911
Name:HOLLINGSWORTH, RYAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:HOLLINGSWORTH
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 1:2825 W ANDREW JOHNSON HWY
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-3216
Mailing Address - Country:US
Mailing Address - Phone:423-307-5757
Mailing Address - Fax:233-075-2414
Practice Address - Street 1:2825 W ANDREW JOHNSON HWY
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-3216
Practice Address - Country:US
Practice Address - Phone:423-307-5757
Practice Address - Fax:423-307-5241
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-01
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN33675183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist