Provider Demographics
NPI:1194825042
Name:HOLCOMB'S PHARMACY, INC
Entity Type:Organization
Organization Name:HOLCOMB'S PHARMACY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GAY
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:WEGEL
Authorized Official - Suffix:
Authorized Official - Credentials:PD
Authorized Official - Phone:870-598-3183
Mailing Address - Street 1:231 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PIGGOTT
Mailing Address - State:AR
Mailing Address - Zip Code:72454-2039
Mailing Address - Country:US
Mailing Address - Phone:870-598-3183
Mailing Address - Fax:870-598-3183
Practice Address - Street 1:231 W MAIN ST
Practice Address - Street 2:
Practice Address - City:PIGGOTT
Practice Address - State:AR
Practice Address - Zip Code:72454-2039
Practice Address - Country:US
Practice Address - Phone:870-598-3183
Practice Address - Fax:870-598-3183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR055393336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy