Provider Demographics
NPI:1770689937
Name:HOLBROOK, PATRICIA (RPH)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:HOLBROOK
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:L
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1415 EVERGREEN RD
Mailing Address - Street 2:
Mailing Address - City:SEVERN
Mailing Address - State:MD
Mailing Address - Zip Code:21144-2613
Mailing Address - Country:US
Mailing Address - Phone:410-551-2689
Mailing Address - Fax:
Practice Address - Street 1:1415 EVERGREEN RD
Practice Address - Street 2:
Practice Address - City:SEVERN
Practice Address - State:MD
Practice Address - Zip Code:21144-2613
Practice Address - Country:US
Practice Address - Phone:410-551-2689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13584183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist