Provider Demographics
NPI:1063770329
Name:HOLLAMON, WILLIAM E JR (RPH)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:E
Last Name:HOLLAMON
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 1:2514 HALLTOWN RD
Mailing Address - Street 2:WALMART PHARMACY 2749
Mailing Address - City:SPRUCE PINE
Mailing Address - State:NC
Mailing Address - Zip Code:28777-5461
Mailing Address - Country:US
Mailing Address - Phone:828-766-8456
Mailing Address - Fax:
Practice Address - Street 1:2514 HALLTOWN RD
Practice Address - Street 2:WALMART PHARMACY 2749
Practice Address - City:SPRUCE PINE
Practice Address - State:NC
Practice Address - Zip Code:28777-5461
Practice Address - Country:US
Practice Address - Phone:828-766-8456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-24
Last Update Date:2014-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11361183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist