Provider Demographics
NPI:1912231200
Name:HOLLAR, JACOB LYNN (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:JACOB
Middle Name:LYNN
Last Name:HOLLAR
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 1:140 BROWNING DR
Mailing Address - Street 2:
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28681-3349
Mailing Address - Country:US
Mailing Address - Phone:828-495-8921
Mailing Address - Fax:
Practice Address - Street 1:10 29TH AVE NE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-1126
Practice Address - Country:US
Practice Address - Phone:828-328-5323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-21
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16364183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist