Provider Demographics
NPI:1134729817
Name:HOLLIDAY, LUKE (RPH)
Entity type:Individual
Prefix:
First Name:LUKE
Middle Name:
Last Name:HOLLIDAY
Suffix:
Gender:M
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:SAMS CLUB PHARMACY
Mailing Address - Street 2:1150 GREELY CHAPEL RD
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45804
Mailing Address - Country:US
Mailing Address - Phone:419-221-1611
Mailing Address - Fax:
Practice Address - Street 1:SAMS CLUB PHARMACY
Practice Address - Street 2:1150 GREELY CHAPEL RD
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804
Practice Address - Country:US
Practice Address - Phone:419-221-1611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03224992183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist