Provider Demographics
NPI:1013511146
Name:HOLCOMB, DAVID TIMOTHY (PHARMD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:TIMOTHY
Last Name:HOLCOMB
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3719 HIGH GABLES W
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-4503
Mailing Address - Country:US
Mailing Address - Phone:678-371-8929
Mailing Address - Fax:
Practice Address - Street 1:4050 WINDER HWY
Practice Address - Street 2:
Practice Address - City:FLOWERY BRANCH
Practice Address - State:GA
Practice Address - Zip Code:30542-3021
Practice Address - Country:US
Practice Address - Phone:770-965-1979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH016499183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist