Organization
HOLDERMAN O2
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES A. HOLDERMAN (OWNER)
(814) 466-2234
Entity
Organization
Contact information
Practice address
119 HONEYSUCKLE DR, BOALSBURG, PA 16827-1524
(814) 466-2234
Mailing address
119 HONEYSUCKLE DR, BOALSBURG, PA 16827-1524
(814) 466-2234
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
81161042
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01742003
—
PA
01
—
HO243990
BLUE SHIELD
PA
Enumeration date
03/27/2007
Last updated
09/06/2023
Update your record
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