Provider Demographics
NPI:1144931999
Name:B3 HEALTHCARE PLLC
Entity type:Organization
Organization Name:B3 HEALTHCARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CLINTON
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLADAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:217-508-5859
Mailing Address - Street 1:1404 ENGLISH OAK DR
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61822-3351
Mailing Address - Country:US
Mailing Address - Phone:217-273-3552
Mailing Address - Fax:
Practice Address - Street 1:319 E MADISON ST STE 2D
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62701-3120
Practice Address - Country:US
Practice Address - Phone:217-508-5859
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center