A.G. Holley State Hospital

LBN: A.G. Holley State Hospital
A.G. Holley State Hospital is an health care organization with primary practice located at 1199 Lantana Rd , Lantana FL 33462-1514. The organization recently has only one registered license in Suppliers / Institutional Pharmacy, which is considered as the primary health care specialty. A.G. Holley State Hospital can be contacted via phone (561) 540-3721, or through Stambaugh, Jerry Jean via phone (561) 540-3721.

Contact Information

Primary practice address
1199 Lantana Rd Lantana FL 33462-1514
Phone: (561) 540-3721
Fax: (561) 545-0372
Website:
Map and Directions
Authorized official contact:
Name: Stambaugh, Jerry Jean RPH
Phone: (561) 540-3721

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Institutional Pharmacy 3336I0012X PH0016562 Florida

Profile Details

NPI number 1295811032
LBN Legal business name A.G. Holley State Hospital
DBA Doing business as
Authorized official Stambaugh, Jerry Jean RPH
Entity Organization
Organization subpart 1 No
Enumeration date Oct 27th, 2006
Last updated Jun 13th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295811032 NPPES
Florida MEDICAID 0215171-00

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