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General NPI Number Information
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NPI Number | 1306906565
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Entity Type | Organization
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Legal Business Name | HOLLADAY HEALTHCARE,INC
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 10/05/2017
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Provider Practice Location Address
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Address Line | 700 S HOLDEN RD
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City | GREENSBORO
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State | NC
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Zip | 27407-2321
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Country | US
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Telephone | 336-547-2988
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Fax | 336-218-0014
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Provider Business Mailing Address
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Address Line | 700 S HOLDEN RD
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City | GREENSBORO
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State | NC
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Zip | 27407-2321
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Country | US
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Telephone | 336-547-2988
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Fax | 336-218-0014
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Authorized Official
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Title or Position | DIRECTOR OF PHARMACY OPERATIONS
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Name | SUSIE BROWN TICKLE
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Credential |
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Telephone | 336-760-3446
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | NC08240
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License Number State | NC
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