Jalicia Deandrea Holt, PharmD
Pharmacist in Dickson, TN. Individual provider (NPI-1).
NPI number1750113437
StatusActive
Last updated in NPPESAug 20, 2024
Details
- NPI
- 1750113437
- Entity type
- Individual (NPI-1)
- Name
- Jalicia Deandrea Holt
- Credential
- PharmD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 20, 2024
- Certification date
- Aug 20, 2024
- Last updated
- Aug 20, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 183500000X | Pharmacist | 48083 | TN | Yes |
Practice location
104 Highway 70 EDickson, TN 37055-2034
Phone 615-446-5585 · Fax 615-446-7770
Mailing address
115 Pheasant Hollow RdDickson, TN 37055-9500
Phone 615-574-8293
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All 33 Pharmacist providers in Dickson · All 802 providers in Dickson
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