Ethlyn Holly, is a medicare enrolled "Social Worker - Clinical" provider in Greensboro, Maryland. Her current practice location is
101 S Academy St, Greensboro, Maryland. You can reach out to her office (for appointments etc.) via phone at
(410) 404-4625.
Ethlyn Holly is licensed to practice in * (Not Available) (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1043694888.
Healthcare Provider's Profile
| Full Name | Ethlyn Holly |
|---|
| Gender | Female |
|---|
| Speciality | Social Worker - Clinical |
|---|
| Location | 101 S Academy St, Greensboro, Maryland |
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1043694888
- Provider Enumeration Date: 07/10/2015
- Last Update Date: 11/29/2023
Medicare PECOS Information:
- PECOS PAC ID: 6305384975
- Enrollment ID: I20240814000497
Medical Identifiers
Medical identifiers for Ethlyn Holly such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1043694888 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| 104100000X | Social Worker | 17713 (Maryland) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ethlyn Holly allows following entities to bill medicare on her behalf.
| Entity Name | Grow Healthcare Group Pa |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20221213001514 |
|---|
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ethlyn Holly is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Ethlyn Holly, Po Box 29, Greensboro, MD 21639-0029 Ph: (410) 404-4625 | Ethlyn Holly, 101 S Academy St, Greensboro, MD 21639-1643 Ph: (410) 404-4625 |
Reviews and Comments