Provider Demographics
NPI:1831722719
Name:HOLLY URGENT CARE PLLC
Entity type:Organization
Organization Name:HOLLY URGENT CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NAMEER
Authorized Official - Middle Name:
Authorized Official - Last Name:SALMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-908-8730
Mailing Address - Street 1:74 CHATEAUX DU LAC
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48430-9140
Mailing Address - Country:US
Mailing Address - Phone:810-813-0653
Mailing Address - Fax:
Practice Address - Street 1:3523 GRANGE HALL RD
Practice Address - Street 2:
Practice Address - City:HOLLY
Practice Address - State:MI
Practice Address - Zip Code:48442-1007
Practice Address - Country:US
Practice Address - Phone:248-382-5791
Practice Address - Fax:248-382-5986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-19
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4301074635OtherLICENSE
MI104852994Medicaid