Provider Demographics
NPI:1225211931
Name:HOLMES, ANGELA MARIA (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:MARIA
Last Name:HOLMES
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 1:600 E GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-1924
Mailing Address - Country:US
Mailing Address - Phone:515-243-4177
Mailing Address - Fax:515-243-3517
Practice Address - Street 1:600 E GRAND AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1924
Practice Address - Country:US
Practice Address - Phone:515-243-4177
Practice Address - Fax:515-243-3517
Is Sole Proprietor?:No
Enumeration Date:2007-12-17
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA19234183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist