Provider Demographics
NPI:1871939892
Name:HOLBROOK MEDICAL CENTER P.L.L.C
Entity type:Organization
Organization Name:HOLBROOK MEDICAL CENTER P.L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:KAFA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALQUBLANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-262-6101
Mailing Address - Street 1:2930 HOLBROOK ST
Mailing Address - Street 2:
Mailing Address - City:HAMTRAMCK
Mailing Address - State:MI
Mailing Address - Zip Code:48212-3512
Mailing Address - Country:US
Mailing Address - Phone:313-262-6101
Mailing Address - Fax:
Practice Address - Street 1:2930 HOLBROOK ST
Practice Address - Street 2:
Practice Address - City:HAMTRAMCK
Practice Address - State:MI
Practice Address - Zip Code:48212-3512
Practice Address - Country:US
Practice Address - Phone:313-262-6101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-16
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty