Provider Demographics
NPI:1982249702
Name:HOLLOWAY, PATRICIA A (HOLLOWAY HOME CARE)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:A
Last Name:HOLLOWAY
Suffix:
Gender:F
Credentials:HOLLOWAY HOME CARE
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:A
Other - Last Name:HOLLO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 55
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:MS
Mailing Address - Zip Code:39051-0055
Mailing Address - Country:US
Mailing Address - Phone:870-612-4900
Mailing Address - Fax:601-654-2233
Practice Address - Street 1:115 S PEARL ST
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:MS
Practice Address - Zip Code:39051-4131
Practice Address - Country:US
Practice Address - Phone:601-654-2233
Practice Address - Fax:601-654-2233
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-15
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker