MEDICARE: DR. KRISTIE J HOLLIDAY 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	03326993	OH

General Provider Information

NPI Number	:	1497807093
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRISTIE J HOLLIDAY PHARMD

Provider Business Mailing Address
First Line	:	5770 KARL RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43229-3604
Country	:	US
Telephone Number	:	614-847-3784
Fax Number	:	614-847-6171

Provider Business Practice Location Address
First Line	:	5770 KARL RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43229-3604
Country	:	US
Telephone Number	:	614-847-3784
Fax Number	:	614-847-6171

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

Provider Enumeration Date	:	01/17/2007
Last Update Date	:	11/12/2020

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