Healthcare Provider Details

I. General information

NPI: 1932837911
Provider Name (Legal Business Name): HOLLY CAUSER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2022
Last Update Date: 08/09/2022
Certification Date: 08/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 MAIN ST
BENTON KY
42025-1119
US

IV. Provider business mailing address

8212 SCALE RD
BENTON KY
42025-7853
US

V. Phone/Fax

Practice location:
  • Phone: 270-527-8636
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number022818
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: