Provider Demographics
NPI:1457951899
Name:HOLCOMB, SABRENA GAYLE (PHARMD)
Entity Type:Individual
Prefix:
First Name:SABRENA
Middle Name:GAYLE
Last Name:HOLCOMB
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:SABRENA
Other - Middle Name:GAYLE
Other - Last Name:POLSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:135 BARRETT LN
Mailing Address - Street 2:
Mailing Address - City:CABOT
Mailing Address - State:AR
Mailing Address - Zip Code:72023-8795
Mailing Address - Country:US
Mailing Address - Phone:501-593-5521
Mailing Address - Fax:
Practice Address - Street 1:1203 S PINE ST
Practice Address - Street 2:
Practice Address - City:CABOT
Practice Address - State:AR
Practice Address - Zip Code:72023-3809
Practice Address - Country:US
Practice Address - Phone:501-628-9211
Practice Address - Fax:501-628-9210
Is Sole Proprietor?:No
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD08512183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist