Provider Demographics
NPI:1942579644
Name:WRIGHT-HOLLOMAN, CHIRA NICOLE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:CHIRA
Middle Name:NICOLE
Last Name:WRIGHT-HOLLOMAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6926 COHASSET CIR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-8312
Mailing Address - Country:US
Mailing Address - Phone:813-786-1982
Mailing Address - Fax:
Practice Address - Street 1:11115 E DR MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:SEFFNER
Practice Address - State:FL
Practice Address - Zip Code:33584-8378
Practice Address - Country:US
Practice Address - Phone:813-689-4049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-26
Last Update Date:2011-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS29692183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist