Individual ProviderEbony L HollowaySocial WorkerBehavioral Health & Social Service ProvidersPractice Address271 W Tulpehocken St, Philadelphia, PA 19144-3209(240) 308-1814PECOS EnrollmentThis provider is enrolled in PECOS as EBONY HOLLOWAY.Based on the most recent information from CMS, provider Ebony L Holloway is legally eligible to order and refer claims for DME services only.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1376268086Provider TypeIndividualFull NameHolloway, Ebony LGenderFemaleSole ProprietorYesEnumeration Date10/5/2022Last Updated10/5/2022Contact InformationPractice LocationPractice Address271 W Tulpehocken St, Philadelphia, PA 19144-3209Phone(240) 308-1814FaxUnlisted FaxMailing LocationMailing Address271 W Tulpehocken St, Philadelphia, PA 19144-3209Phone(240) 308-1814FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseCW021990Pennsylvania