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General NPI Number Information
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NPI Number | 1417086430
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Entity Type | Individual
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Provider Name | HOLLY D GENTRY PHARMD
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Gender | Female
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 303 GREEN ST E BLDG A
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City | WILSON
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State | NC
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Zip | 27893-4105
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Country | US
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Telephone | 252-243-1224
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Fax | 252-243-1223
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Provider Business Mailing Address
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Address Line | 103 ASHWORTH DR
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City | GOLDSBORO
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State | NC
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Zip | 27530-5553
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Country | US
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Telephone | 919-734-4449
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 16807
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License Number State | NC
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