Healthcare Provider Details

I. General information

NPI: 1790883726
Provider Name (Legal Business Name): HOLLAND DRUG CO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 11/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1704 CHEROKEE AVE SW
CULLMAN AL
35055-5333
US

IV. Provider business mailing address

1704 CHEROKEE AVE SW
CULLMAN AL
35055-5333
US

V. Phone/Fax

Practice location:
  • Phone: 256-734-1935
  • Fax: 256-739-9346
Mailing address:
  • Phone: 256-734-1935
  • Fax: 256-739-9346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number111843
License Number StateAL

VIII. Authorized Official

Name: KEVIN HOLLAND
Title or Position: OWNER PRESIDENT
Credential:
Phone: 256-734-1935