Provider Demographics
NPI:1528728284
Name:LY, HOLLY CHHUN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:CHHUN
Last Name:LY
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 1:4601A SANGAMORE RD
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20816-2545
Mailing Address - Country:US
Mailing Address - Phone:301-229-3262
Mailing Address - Fax:
Practice Address - Street 1:4601A SANGAMORE RD
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20816-2545
Practice Address - Country:US
Practice Address - Phone:301-229-3262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-22
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD28254183500000X
CA85227183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist