Provider Demographics
NPI:1285840082
Name:HOLLOMAN'S HOME CARE, INC.
Entity Type:Organization
Organization Name:HOLLOMAN'S HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLOMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-934-1886
Mailing Address - Street 1:839A S BRIGHTLEAF BLVD
Mailing Address - Street 2:BUILDING 2
Mailing Address - City:SMITHFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27577-4392
Mailing Address - Country:US
Mailing Address - Phone:919-934-1886
Mailing Address - Fax:919-934-1813
Practice Address - Street 1:839A S BRIGHTLEAF BLVD
Practice Address - Street 2:BUILDING 2
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-4392
Practice Address - Country:US
Practice Address - Phone:919-934-1886
Practice Address - Fax:919-934-1813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC2431251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6600999Medicaid
NC3409632Medicaid