Provider Demographics
NPI:1225185507
Name:HOLLY SPRINGS MEDICAL CENTER, PA
Entity Type:Organization
Organization Name:HOLLY SPRINGS MEDICAL CENTER, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:
Authorized Official - Last Name:STEIMLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-552-5845
Mailing Address - Street 1:500 HOLLY SPRINGS ROAD
Mailing Address - Street 2:SUITE #100
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-6204
Mailing Address - Country:US
Mailing Address - Phone:919-552-5845
Mailing Address - Fax:919-567-3109
Practice Address - Street 1:500 HOLLY SPRINGS ROAD
Practice Address - Street 2:SUITE #100
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-6204
Practice Address - Country:US
Practice Address - Phone:919-552-5845
Practice Address - Fax:919-567-3109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC207Q00000X
NC9901648207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89013P4Medicaid
NC89127WJMedicaid
NC2281676CMedicare PIN
NC2328021Medicare PIN
NC89127WJMedicaid