Provider Demographics
NPI:1225473523
Name:HOLLAND DISCOUNT PHARMACY LLC
Entity Type:Organization
Organization Name:HOLLAND DISCOUNT PHARMACY LLC
Other - Org Name:HOLLAND DISCOUNT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BILAL
Authorized Official - Middle Name:
Authorized Official - Last Name:SALIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-345-7253
Mailing Address - Street 1:909 S MCCORD RD STE 1
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:OH
Mailing Address - Zip Code:43528-8370
Mailing Address - Country:US
Mailing Address - Phone:419-865-7777
Mailing Address - Fax:419-865-3300
Practice Address - Street 1:909 S MCCORD RD STE 1
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:OH
Practice Address - Zip Code:43528-8370
Practice Address - Country:US
Practice Address - Phone:419-865-7777
Practice Address - Fax:419-865-3300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-01
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336C0004X
OH0223036503336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2140273OtherPK
OH0084432Medicaid