Provider Demographics
NPI:1578695623
Name:HOLLAND CENTER RX LLC
Entity Type:Organization
Organization Name:HOLLAND CENTER RX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SUMEET
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-945-0015
Mailing Address - Street 1:621 MILFORD WARREN GLEN RD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08848-1631
Mailing Address - Country:US
Mailing Address - Phone:908-995-0015
Mailing Address - Fax:908-995-9400
Practice Address - Street 1:621 MILFORD WARREN GLEN RD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:NJ
Practice Address - Zip Code:08848-1631
Practice Address - Country:US
Practice Address - Phone:908-995-0015
Practice Address - Fax:908-995-9400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS006447003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2166817OtherPK
NJ0099031Medicaid
NJ0099031Medicaid