Organization
P O HOLLIDAY III FAMILY LEASING CO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER O HOLLIDAY III MD (OWNER)
(478) 474-0394
Entity
Organization
Contact information
Practice address
420 CHARTER BLVD, STE 402, MACON, GA 31210-4854
(478) 474-0394
(478) 477-5509
Mailing address
420 CHARTER BLVD, STE 402, MACON, GA 31210-4854
(478) 474-0394
(478) 477-5509
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
026557
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00289528B
—
GA
Enumeration date
03/23/2009
Last updated
08/21/2009
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