Provider Demographics
NPI: | 1225112782 |
---|---|
Name: | HOLLANDS DRUG INC |
Entity Type: | Organization |
Organization Name: | HOLLANDS DRUG INC |
Other - Org Name: | HOLLANDS APOTHECARY |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | WALTER |
Authorized Official - Middle Name: | EVERETT |
Authorized Official - Last Name: | HOLLAND |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DPH |
Authorized Official - Phone: | 931-388-4233 |
Mailing Address - Street 1: | 1114 WEST 7TH STREET |
Mailing Address - Street 2: | |
Mailing Address - City: | COLUMBIA |
Mailing Address - State: | TN |
Mailing Address - Zip Code: | 38401 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 931-388-8833 |
Mailing Address - Fax: | 931-388-3561 |
Practice Address - Street 1: | 1114 WEST 7TH STREET |
Practice Address - Street 2: | |
Practice Address - City: | COLUMBIA |
Practice Address - State: | TN |
Practice Address - Zip Code: | 38401 |
Practice Address - Country: | US |
Practice Address - Phone: | 931-388-8833 |
Practice Address - Fax: | 931-388-3561 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-10-24 |
Last Update Date: | 2023-03-07 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 333600000X | Suppliers | Pharmacy |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
443364S | Other | NCPDP | |
BH6518116 | Other | DEA |