Provider Demographics
NPI:1104480805
Name:HOLVOET, SARA FLORENCE (PHARM D)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:FLORENCE
Last Name:HOLVOET
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:FLORENCE
Other - Last Name:BLINT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3064 HIGHWAY 16
Mailing Address - Street 2:
Mailing Address - City:WEVER
Mailing Address - State:IA
Mailing Address - Zip Code:52658-9534
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:300 N PARK DR
Practice Address - Street 2:
Practice Address - City:KEOKUK
Practice Address - State:IA
Practice Address - Zip Code:52632-2200
Practice Address - Country:US
Practice Address - Phone:319-524-4071
Practice Address - Fax:319-524-4073
Is Sole Proprietor?:No
Enumeration Date:2019-04-28
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA18982183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA18982OtherIOWA LICENSE NUMBER