Holly Elizabeth Colbert
Individual provider Active NPI Pharmacist · Aberdeen, MS
NPI 1982912333 · NPPES record last updated Sep 20, 2010
Key facts
- NPI
- 1982912333
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- E08926 (MS)
- Practice address
- 107 N Meridian St
Aberdeen, MS 39730-2635 - Phone
- (662) 369-0060
- Fax
- (662) 369-6324
- NPI assigned
- Sep 20, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E08926 | MS | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hometown Pharmacy LLC | Current | Accepting new patients | |
| Freds Stores of Tennessee Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | E08926 | MS | Yes |
Addresses
Primary practice location
107 N Meridian St
Aberdeen, MS 39730-2635
Mailing address
107 N Meridian St
Aberdeen, MS 39730-2635
Phone (662) 369-0060
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00330311 | Medicaid | MS |
Other providers in Aberdeen, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 20, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.