Provider Demographics
NPI:1215956651
Name:HOLLIFIELD, ROBERT ANDREW (RPH)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:ANDREW
Last Name:HOLLIFIELD
Suffix:
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 1:165 GENTLE WINDS LN
Mailing Address - Street 2:
Mailing Address - City:BOSTIC
Mailing Address - State:NC
Mailing Address - Zip Code:28018-5707
Mailing Address - Country:US
Mailing Address - Phone:828-245-4448
Mailing Address - Fax:
Practice Address - Street 1:139 E MAIN ST
Practice Address - Street 2:
Practice Address - City:FOREST CITY
Practice Address - State:NC
Practice Address - Zip Code:28043-3125
Practice Address - Country:US
Practice Address - Phone:828-245-9215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC07356183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist