Healthcare Provider Details

I. General information

NPI: 1215877477
Provider Name (Legal Business Name): MARCOS JOHN HOLLAND EMT-B
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5201 LEE RD
BUZZARDS BAY MA
02542-1313
US

IV. Provider business mailing address

5201 LEE RD
BUZZARDS BAY MA
02542-1313
US

V. Phone/Fax

Practice location:
  • Phone: 206-815-7461
  • Fax: 508-968-6581
Mailing address:
  • Phone: 206-815-7461
  • Fax: 508-968-6581

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License NumberE3528872
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: