Provider Demographics
NPI:1013076017
Name:DHI INC.
Entity Type:Organization
Organization Name:DHI INC.
Other - Org Name:ST. CHARLES REXALL DRUG CO.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER AND PIC
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLAWAY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:636-946-6606
Mailing Address - Street 1:550 1ST CAPITOL DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63301-2726
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:550 1ST CAPITOL DR
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-2726
Practice Address - Country:US
Practice Address - Phone:636-946-6606
Practice Address - Fax:636-723-1366
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DHI INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-06
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO005065333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO600279905Medicaid
2601474OtherOTHER ID NUMBER-COMMERCIAL NUMBER