Provider Demographics
NPI:1447991989
Name:HOLMES, TRAVIS JOHN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TRAVIS
Middle Name:JOHN
Last Name:HOLMES
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-0849
Mailing Address - Country:US
Mailing Address - Phone:252-917-6289
Mailing Address - Fax:
Practice Address - Street 1:4600 E 10TH ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-0849
Practice Address - Country:US
Practice Address - Phone:252-917-6289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-06
Last Update Date:2024-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC31092183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist