Provider Demographics
NPI:1457757114
Name:WHOLISTIC FAMILY HEALTHCARE, INC.
Entity Type:Organization
Organization Name:WHOLISTIC FAMILY HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SIMEON
Authorized Official - Middle Name:
Authorized Official - Last Name:POLLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, LMT
Authorized Official - Phone:301-495-0303
Mailing Address - Street 1:10863 LOCKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-1552
Mailing Address - Country:US
Mailing Address - Phone:301-495-0303
Mailing Address - Fax:
Practice Address - Street 1:8830 CAMERON ST STE 602
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4158
Practice Address - Country:US
Practice Address - Phone:301-495-0303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-07
Last Update Date:2014-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01179171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDBG43OtherCAREFIRST BC/BS