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NPI Code Detail

MEDICARE: LUCAS DANIEL HOLT PHARMD

MEDICARE:   LUCAS DANIEL HOLT  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
1183500000XPharmacist18338CO
2183500000XPharmacist45444TX

General Provider Information

NPI Number : 1477996692
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUCAS DANIEL HOLT PHARMD
Provider Business Mailing Address
First Line : 9225 N UNION BLVD
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80920-7826
Country : US
Telephone Number : 719-522-2201
Fax Number : 719-522-2204
Provider Business Practice Location Address
First Line : 9225 N UNION BLVD
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80920-7826
Country : US
Telephone Number : 719-522-2201
Fax Number : 719-522-2204
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2013
Last Update Date : 04/08/2013

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Directions to “ LUCAS DANIEL HOLT PHARMD” Practice Location

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