Provider Demographics
NPI:1790883726
Name:HOLLAND DRUG CO INC
Entity Type:Organization
Organization Name:HOLLAND DRUG CO INC
Other - Org Name:WELLS TURNER FAMILY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-734-1935
Mailing Address - Street 1:1704 CHEROKEE AVE SW
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35055-5333
Mailing Address - Country:US
Mailing Address - Phone:256-734-1935
Mailing Address - Fax:256-739-9346
Practice Address - Street 1:1704 CHEROKEE AVE SW
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-5333
Practice Address - Country:US
Practice Address - Phone:256-734-1935
Practice Address - Fax:256-739-9346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2009-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
AL1118433336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
0114431OtherNCPDP PROVIDER IDENTIFICATION NUMBER
AL100003213Medicaid
3974720001Medicare NSC