MEDICARE: HOLIDAY ROSS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	07545	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	07545	OTHER	AR	PHARMACIST LICENSE

General Provider Information

NPI Number	:	1245226224
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOLIDAY ROSS

Provider Business Mailing Address
First Line	:	416 MANOR RD
Second Line	:
City	:	PRESCOTT
State	:	AR
Zip	:	71857-2801
Country	:	US
Telephone Number	:	870-887-5020
Fax Number	:	870-887-2113

Provider Business Practice Location Address
First Line	:	1430 W 1ST ST N
Second Line	:
City	:	PRESCOTT
State	:	AR
Zip	:	71857-3339
Country	:	US
Telephone Number	:	870-887-2717
Fax Number	:	870-887-2113

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/23/2005
Last Update Date	:	07/08/2007

Similar Medicare Providers

1528064367 — SUPER D DRUG ACQUISITION CO.
Practice Location Address:

1430 W 1ST ST N
PRESCOTT, AR
71857-3339

Practice Phone: 870-887-2717
Practice Fax: 870-887-2113

1912904251 — CHARLES A. VERMONT M.D.
Practice Location Address:

1480 W 1ST ST N
PRESCOTT, AR
71857-3339

Practice Phone: 870-887-2669
Practice Fax: 870-887-5373

1770583189 — THOMAS A FOX MD
Practice Location Address:

1440 W 1ST ST N
PRESCOTT, AR
71857-3339

Practice Phone: 870-887-8001
Practice Fax:

1841286952 — DR. GARY LEE LEWIS
Practice Location Address:

1430 W 1ST ST N
PRESCOTT, AR
71857-3339

Practice Phone: 870-887-2717
Practice Fax: 870-887-2113

1770520900 — DR. SAGE VERMONT THURLBY M.D.
Practice Location Address:

1480 W 1ST ST N
PRESCOTT, AR
71857-3339

Practice Phone: 870-887-2669
Practice Fax: 870-887-5373

1922120765 — OLIVER MARC SCROGGINS MHPP
Practice Location Address:

1484 W 1ST ST N
PRESCOTT, AR
71857-3339

Practice Phone: 870-887-1078
Practice Fax:

Directions to “ HOLIDAY ROSS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.