Provider Demographics
NPI:1205821246
Name:HOLSOMBECK, CAROLINE CLAUDIA (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:CLAUDIA
Last Name:HOLSOMBECK
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46380 ACADEMY DR
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-3520
Mailing Address - Country:US
Mailing Address - Phone:734-904-0729
Mailing Address - Fax:
Practice Address - Street 1:6100 N HAGGERTY RD
Practice Address - Street 2:CANTON MEDICAL CENTER PHARMACY
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-3683
Practice Address - Country:US
Practice Address - Phone:734-981-3002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2013-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302032598183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist