Healthcare Provider Details

I. General information

NPI: 1841221850
Provider Name (Legal Business Name): HOLLAND HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 02/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1911 E DIVISION ST STE C
MOUNT VERNON WA
98274-6703
US

IV. Provider business mailing address

PO BOX 1406
MOUNT VERNON WA
98273-1406
US

V. Phone/Fax

Practice location:
  • Phone: 360-424-8607
  • Fax: 360-424-7430
Mailing address:
  • Phone: 360-424-7829
  • Fax: 360-424-9053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: JERRY A WILLINS
Title or Position: PRESIDENT/CEO
Credential: RPH
Phone: 360-424-7829