Provider Demographics
NPI:1700488392
Name:HOLMES, DAVID (MA, PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:HOLMES
Suffix:
Gender:M
Credentials:MA, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 CHESTNUT ST APT 3
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:MA
Mailing Address - Zip Code:01562-2467
Mailing Address - Country:US
Mailing Address - Phone:757-692-9416
Mailing Address - Fax:
Practice Address - Street 1:54 PLAIN ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01851-4419
Practice Address - Country:US
Practice Address - Phone:978-453-7538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-10
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202204803183500000X
MAPH240130183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist