Provider Demographics
NPI:1548235013
Name:HOLMAC INC
Entity Type:Organization
Organization Name:HOLMAC INC
Other - Org Name:RX EXPRESS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCMELLON
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:228-588-2888
Mailing Address - Street 1:PO BOX 790
Mailing Address - Street 2:
Mailing Address - City:HURLEY
Mailing Address - State:MS
Mailing Address - Zip Code:39555-0790
Mailing Address - Country:US
Mailing Address - Phone:228-588-2888
Mailing Address - Fax:228-588-2890
Practice Address - Street 1:7100 HIGHWAY 614
Practice Address - Street 2:
Practice Address - City:HURLEY
Practice Address - State:MS
Practice Address - Zip Code:39555-7395
Practice Address - Country:US
Practice Address - Phone:228-588-2888
Practice Address - Fax:228-588-2890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-20
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS04320/01.14333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00330449Medicaid
MS00330449Medicaid