MEDICARE: MARCIA HOLLOMAN-LAND

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1952614018
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCIA HOLLOMAN-LAND

Provider Business Mailing Address
First Line	:	5517 KEYDET DR
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-7312
Country	:	US
Telephone Number	:	757-320-7961
Fax Number	:

Provider Business Practice Location Address
First Line	:	5517 KEYDET DR
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-7312
Country	:	US
Telephone Number	:	757-320-7961
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2010
Last Update Date	:	07/19/2010

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Directions to “ MARCIA HOLLOMAN-LAND ” Practice Location

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