Provider Demographics
NPI:1740718329
Name:HOLLIDAY, EDANA TAMAR (PHARMD)
Entity type:Individual
Prefix:DR
First Name:EDANA
Middle Name:TAMAR
Last Name:HOLLIDAY
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 1:7308 E INDEPENDENCE BLVD
Mailing Address - Street 2:ST I
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215
Mailing Address - Country:US
Mailing Address - Phone:704-537-0909
Mailing Address - Fax:
Practice Address - Street 1:7308 E INDEPENDENCE BLVD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28227-9448
Practice Address - Country:US
Practice Address - Phone:704-537-0909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC36811183500000X
NC26560183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist