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General NPI Number Information
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NPI Number | 1982402855
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Entity Type | Individual
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Provider Name | LORRAINE ESTELLE HOLLY PHARMD
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Gender | Female
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Dates
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Enumeration Date | 03/05/2025
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 1555 QUAIL ST
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City | LAKEWOOD
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State | CO
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Zip | 80215-6251
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Country | US
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Telephone | 303-233-1001
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Fax |
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Provider Business Mailing Address
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Address Line | 6009 NILE CIR
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City | GOLDEN
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State | CO
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Zip | 80403-2671
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Country | US
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Telephone | 623-628-4596
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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 | 0025071
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License Number State | CO
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