Provider Demographics
NPI:1417086430
Name:GENTRY, HOLLY D (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:D
Last Name:GENTRY
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 1:103 ASHWORTH DR
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27530-5553
Mailing Address - Country:US
Mailing Address - Phone:919-734-4449
Mailing Address - Fax:
Practice Address - Street 1:303 GREEN ST E BLDG A
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-4105
Practice Address - Country:US
Practice Address - Phone:252-243-1224
Practice Address - Fax:252-243-1223
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16807183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist