Organization
HOLLANDALE PRIMARY CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LELA PERKINS (MANAGING ADMINISTRATOR)
(662) 827-7568
Entity
Organization
Contact information
Practice address
1257 HWY 61 SOUTH, HOLLANDALE, MS 38748
(662) 827-2214
(662) 827-5019
Mailing address
PO BOX 247, HOLLANDALE, MS 38748-0247
(662) 827-2214
(662) 827-5019
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0914125
—
MS
Enumeration date
06/20/2005
Last updated
08/22/2020
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