Provider Demographics
NPI:1417557281
Name:SCARLETTE, HOLLY GWEN (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:GWEN
Last Name:SCARLETTE
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1956 S HORNER BLVD
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-5841
Mailing Address - Country:US
Mailing Address - Phone:919-775-4361
Mailing Address - Fax:
Practice Address - Street 1:1956 S HORNER BLVD
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-5841
Practice Address - Country:US
Practice Address - Phone:919-775-4361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30089183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist