Organization
PREMIER PEDIATRIC HEALTHCARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY GRETCHEN HOLLOWAY RN (MEMBER)
(662) 934-0206
Entity
Organization
Contact information
Practice address
287 GREEN OAK LN, MADISON, MS 39110-8213
(662) 934-0206
Mailing address
287 GREEN OAK LN, MADISON, MS 39110-8213
(662) 934-0206
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
11/13/2016
Last updated
11/13/2016
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