Provider Demographics
NPI:1033225008
Name:HOLLAND & HOLLAND EYE CARE CENTER OPTOMETRY PLLC
Entity Type:Organization
Organization Name:HOLLAND & HOLLAND EYE CARE CENTER OPTOMETRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:VERNON
Authorized Official - Last Name:HOLLAND
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:919-828-9085
Mailing Address - Street 1:603 NEW BERN AVE
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27601
Mailing Address - Country:US
Mailing Address - Phone:919-828-9085
Mailing Address - Fax:919-828-9086
Practice Address - Street 1:603 NEW BERN AVE
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27601
Practice Address - Country:US
Practice Address - Phone:919-828-9085
Practice Address - Fax:919-828-9086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8909411Medicaid
NC2468813AMedicare PIN