MEDICARE: THE HOLLOWAY GROUP, 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	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1356589188
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE HOLLOWAY GROUP, INC.

Provider Business Mailing Address
First Line	:	6613 N MERIDIAN AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73116-1423
Country	:	US
Telephone Number	:	405-812-9483
Fax Number	:	405-603-8455

Provider Business Practice Location Address
First Line	:	6613 NORTH MERIDIAN AVENUE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73118
Country	:	US
Telephone Number	:	405-812-9483
Fax Number	:	405-603-8455

Authorized Official
Title or Position	:	C.E.O.
Name	:	DR. WILLIS HOLLOWAY
Credential	:
Telephone Number	:	405-812-9483

Provider Enumeration Date	:	02/02/2009
Last Update Date	:	02/02/2009

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