Provider Demographics
NPI:1649917006
Name:HOLLOMAN, LORA DAWNELL (PHARMD)
Entity type:Individual
Prefix:
First Name:LORA
Middle Name:DAWNELL
Last Name:HOLLOMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3430 SANDYSTONE CIR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28311-2503
Mailing Address - Country:US
Mailing Address - Phone:910-480-8397
Mailing Address - Fax:
Practice Address - Street 1:3500 DAVIS DR
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-8819
Practice Address - Country:US
Practice Address - Phone:919-463-7990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-17
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC31091183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist