Provider Demographics
NPI:1932707023
Name:HOLMAN, DAVIN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DAVIN
Middle Name:
Last Name:HOLMAN
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 1:5069 S 174TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68135-1449
Mailing Address - Country:US
Mailing Address - Phone:402-699-9342
Mailing Address - Fax:
Practice Address - Street 1:8809 W CENTER RD
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-2044
Practice Address - Country:US
Practice Address - Phone:402-384-9085
Practice Address - Fax:402-391-4924
Is Sole Proprietor?:No
Enumeration Date:2020-10-12
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10909183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist