Holiday Lung And Sleep Center | |
107 Brandon Rd Starkville MS 39759-2521 | |
(662) 324-1291 | |
Not Available |
Full Name | Holiday Lung And Sleep Center |
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Speciality | Clinic/Center |
Location | 107 Brandon Rd, Starkville, Mississippi |
Authorized Official Name and Position | James H. Jackson (CEO) |
Authorized Official Contact | 6626152500 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Holiday Lung And Sleep Center Po Box 1326 Starkville MS 39760-1326 Ph: () - | Holiday Lung And Sleep Center 107 Brandon Rd Starkville MS 39759-2521 Ph: (662) 324-1291 |
NPI Number | 1639283740 |
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Provider Enumeration Date | 08/18/2006 |
Last Update Date | 10/03/2022 |
Medicare PECOS PAC ID | 5092715086 |
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Medicare Enrollment ID | O20061221000289 |
Identifier | Type | State | Issuer |
---|---|---|---|
1639283740 | NPI | - | NPPES |
02601532 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 11-269 (Mississippi) | Primary |
Provider Name | Harry R Holliday |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1053335372 PECOS PAC ID: 0547260549 Enrollment ID: I20061221000309 |
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