Provider Demographics
NPI:1043818297
Name:HOLMGREN, ELIZABETH BENSON (PHARMD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:BENSON
Last Name:HOLMGREN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:SITKA
Mailing Address - State:AK
Mailing Address - Zip Code:99835-7540
Mailing Address - Country:US
Mailing Address - Phone:907-966-2110
Mailing Address - Fax:907-966-2468
Practice Address - Street 1:106 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:SITKA
Practice Address - State:AK
Practice Address - Zip Code:99835-7540
Practice Address - Country:US
Practice Address - Phone:907-966-2110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-10
Last Update Date:2020-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1268183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist