Marvin L. Holloman

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

69000690A Issued in IN

Legal business name

MARVIN L. HOLLOMAN

Doing business as

M & L Medical Supplies

Practice address

425 Joliet St Ste 125
Dyer, IN 46311-1775

Phone

(708) 625-5681

NPI assigned

Nov 17, 2017

Organization subpart

No

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

Authorized official

Name

Mrs. Latoya Holloman

Title

Admin

Phone

(708) 625-5681

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• M & L Medical Supplies Doing business as

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

{
    "created_epoch": "1510876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510876800000",
    "number": "1164936787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21706 PETERSON AVE",
            "city": "SAUK VILLAGE",
            "state": "IL",
            "postal_code": "604114438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 JOLIET ST STE 125",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463111775",
            "telephone_number": "708-625-5681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARVIN L. HOLLOMAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-17",
        "last_updated": "2017-11-17",
        "status": "A",
        "authorized_official_last_name": "HOLLOMAN",
        "authorized_official_first_name": "LATOYA",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "708-625-5681",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IN",
            "license": "69000690A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "69000690A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "M & L Medical Supplies",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mark K Chang MD (Midwest SpineCare, SC)
• Mark K Chang MD (Midwest Spinecare)
• Maria Marrero, NP
• Lynnette Martin-Richey
• Sarah K Martinez, DPT
• Michelle Lynn Masterson, NP-C
• Mbwoude, Inc. (APT Plus)
• Mariel McElfresh, LCSW
• Hope McGee
• Megan Rose McKenzie, MS, LAT, ATC

• Durable Medical Equipment & Medical Supplies in Dyer, IN
• Providers in Dyer, IN by specialty
• Durable Medical Equipment & Medical Supplies in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2017; 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.