Provider Demographics
NPI:1457326720
Name:HOLSTON, HARRY LLOYD JR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:LLOYD
Last Name:HOLSTON
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8708 COLEMAN HOMESTEAD RD
Mailing Address - Street 2:
Mailing Address - City:MOSS POINT
Mailing Address - State:MS
Mailing Address - Zip Code:39562-9375
Mailing Address - Country:US
Mailing Address - Phone:228-588-2332
Mailing Address - Fax:
Practice Address - Street 1:13286 N WINTZELL AVE
Practice Address - Street 2:
Practice Address - City:BAYOU LA BATRE
Practice Address - State:AL
Practice Address - Zip Code:36509-2146
Practice Address - Country:US
Practice Address - Phone:251-824-7455
Practice Address - Fax:251-824-7450
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL10991183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
BR9610470OtherDEA