MEDICARE: HOLMAC, INC.

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	332B00000X	Durable Medical Equipment & Medical Supplies	00440559	MS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184764193
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOLMAC, INC.

Provider Business Mailing Address
First Line	:	PO BOX 10
Second Line	:
City	:	HURLEY
State	:	MS
Zip	:	39555-0010
Country	:	US
Telephone Number	:	228-588-2888
Fax Number	:	228-588-2890

Provider Business Practice Location Address
First Line	:	7100 HIGHWAY 614 # H
Second Line	:
City	:	MOSS POINT
State	:	MS
Zip	:	39562-7395
Country	:	US
Telephone Number	:	228-588-2888
Fax Number	:	228-588-2890

Authorized Official
Title or Position	:	PHARMACIST, PRESIDENT
Name	:	MR. STEVE MCMELLON
Credential	:	RPH
Telephone Number	:	228-588-2888

Provider Enumeration Date	:	02/07/2007
Last Update Date	:	08/22/2020

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