P O Holliday III Family Leasing Co LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

026557 Issued in GA

Legal business name

P O HOLLIDAY III FAMILY LEASING CO LLC

Practice address

420 Charter Blvd
Ste 402
Macon, GA 31210-4854

Phone

(478) 474-0394

Fax

(478) 477-5509

NPI assigned

Mar 23, 2009

Last updated

Aug 21, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Peter O Holliday III, MD

Title

Owner

Phone

(478) 474-0394

Specialties & licenses 1

Addresses

Other identifiers 1

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Elite MRI of Laurens, LLC

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Dublin, GA
  • NPI 1699860130

  Member Of

  NPD member

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1237766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250812800000",
    "number": "1124269089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 CHARTER BLVD",
            "address_2": "STE 402",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312104854",
            "telephone_number": "478-474-0394",
            "fax_number": "478-477-5509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 CHARTER BLVD",
            "address_2": "STE 402",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312104854",
            "telephone_number": "478-474-0394",
            "fax_number": "478-477-5509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "P O HOLLIDAY III FAMILY LEASING CO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-23",
        "last_updated": "2009-08-21",
        "status": "A",
        "authorized_official_last_name": "HOLLIDAY",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "478-474-0394",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "GA",
            "license": "026557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00289528B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pagemed, LLC

• Durable Medical Equipment & Medical Supplies in Macon, GA
• Providers in Macon, GA by specialty
• Durable Medical Equipment & Medical Supplies in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.