Basic Information
| Provider Information | |||||||||
| NPI: | 1679173991 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOLLAND | ||||||||
| FirstName: | BRANDON | ||||||||
| MiddleName: | K | ||||||||
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| Credential: | PHARM. D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13400 BECKENHAM DR | ||||||||
| Address2: | |||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722123712 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8702172815 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 19301 CANTRELL RD | ||||||||
| Address2: | |||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722234457 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5018689854 | ||||||||
| FaxNumber: | 5018688438 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/27/2020 | ||||||||
| LastUpdateDate: | 10/27/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/27/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 56119 | TX | N | Pharmacy Service Providers | Pharmacist | 183500000X | PD11936 | AR | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.