Provider Demographics
NPI:1528349552
Name:MACKEY, HOLLY (PHARMD)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:MACKEY
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 1:3160 EAGLE CLAW PL
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80108-7400
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9397 CROWN CREST BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-8575
Practice Address - Country:US
Practice Address - Phone:303-339-5333
Practice Address - Fax:303-339-5337
Is Sole Proprietor?:No
Enumeration Date:2011-09-03
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO18801183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist