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General NPI Number Information
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NPI Number | 1891290755
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Entity Type | Individual
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Provider Name | MICHAEL WILLIAM HOLCOMB PHARMACIST
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Gender | Male
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Dates
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Enumeration Date | 03/24/2018
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Last Update Date | 03/24/2018
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Provider Practice Location Address
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Address Line | 15412 PATRICK HENRY HWY
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City | AMELIA COURT HOUSE
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State | VA
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Zip | 23002-4725
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Country | US
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Telephone | 804-561-6885
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Fax |
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Provider Business Mailing Address
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Address Line | 2644 ACADEMY RD
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City | POWHATAN
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State | VA
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Zip | 23139-5824
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Country | US
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Telephone | 804-426-5723
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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 | 0202010258
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License Number State | VA
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