Provider Demographics
NPI:1588679468
Name:HOLMES PHARMACY INC
Entity Type:Organization
Organization Name:HOLMES PHARMACY INC
Other - Org Name:HOLMES PHARMACY AT HAMILTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:PRATHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-628-9995
Mailing Address - Street 1:PO BOX 407
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:GA
Mailing Address - Zip Code:31811-0407
Mailing Address - Country:US
Mailing Address - Phone:706-628-9995
Mailing Address - Fax:706-689-9992
Practice Address - Street 1:141 N COLLEGE ST
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:GA
Practice Address - Zip Code:31811-6000
Practice Address - Country:US
Practice Address - Phone:706-628-9995
Practice Address - Fax:706-628-9992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
GAPHRE0087693336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2014501OtherPK
GA130317948AMedicaid
GA130317948BMedicaid