MEDICARE: DR. EMILY LAUREN HOLLEY PHARMD

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	27545	TN

General Provider Information

NPI Number	:	1285989061
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EMILY LAUREN HOLLEY PHARMD

Provider Business Mailing Address
First Line	:	1717 FORT HENRY DR
Second Line	:
City	:	KINGSPORT
State	:	TN
Zip	:	37664-3228
Country	:	US
Telephone Number	:	423-247-3124
Fax Number	:	423-247-5907

Provider Business Practice Location Address
First Line	:	1717 FORT HENRY DR
Second Line	:
City	:	KINGSPORT
State	:	TN
Zip	:	37664-3228
Country	:	US
Telephone Number	:	423-247-3124
Fax Number	:	423-247-5907

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

Provider Enumeration Date	:	07/18/2012
Last Update Date	:	07/18/2012

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