Provider Demographics
NPI:1164706198
Name:HOLT, CAROLE ANN C (RPH)
Entity Type:Individual
Prefix:
First Name:CAROLE ANN
Middle Name:C
Last Name:HOLT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 AMERICAN DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29505-6076
Mailing Address - Country:US
Mailing Address - Phone:843-629-8760
Mailing Address - Fax:843-629-2696
Practice Address - Street 1:611 HIGHWAY 301 N
Practice Address - Street 2:RITE AID
Practice Address - City:DILLON
Practice Address - State:SC
Practice Address - Zip Code:29536-2446
Practice Address - Country:US
Practice Address - Phone:843-774-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-10
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6746183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist