Individual ProviderHolly Beth LutmerPharmacistPharmacy Service ProvidersPractice Address4901 Kinsey Dr Apt 1723, Tyler, TX 75703-3033(903) 705-2797PECOS EnrollmentBased on the most recent information from CMS, provider Holly Beth Lutmer does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1528673597Provider TypeIndividualFull NameLutmer, Holly BethGenderFemaleSole ProprietorNoEnumeration Date9/15/2020Last Updated9/15/2020Contact InformationPractice LocationPractice Address4901 Kinsey Dr Apt 1723, Tyler, TX 75703-3033Phone(903) 705-2797FaxUnlisted FaxMailing LocationMailing Address4901 Kinsey Dr Apt 1723, Tyler, TX 75703-3033Phone(903) 705-2797FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode183500000XPrimaryDescriptionPharmacistPharmacy Service ProvidersLicense67083Texas