Provider Demographics
NPI:1063536878
Name:HOLLAND HEALTH SERVICE INC
Entity type:Organization
Organization Name:HOLLAND HEALTH SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:C
Authorized Official - Last Name:HOLLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-862-2165
Mailing Address - Street 1:PO BOX 704
Mailing Address - Street 2:1905 SOUTH ADAMS STREET
Mailing Address - City:FULTON
Mailing Address - State:MS
Mailing Address - Zip Code:38843-0704
Mailing Address - Country:US
Mailing Address - Phone:662-862-2165
Mailing Address - Fax:662-862-2167
Practice Address - Street 1:1905 S ADAMS ST
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:MS
Practice Address - Zip Code:38843-8738
Practice Address - Country:US
Practice Address - Phone:662-862-2165
Practice Address - Fax:662-862-2167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR850493363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty