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General NPI Number Information
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NPI Number | 1104841808
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Entity Type | Organization
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Legal Business Name | HOLLAND PHARMACY LLC
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 01/30/2022
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Provider Practice Location Address
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Address Line | 700 MICHIGAN AVE
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City | HOLLAND
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State | MI
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Zip | 49423-6944
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Country | US
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Telephone | 616-392-8507
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Fax | 616-392-8681
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Provider Business Mailing Address
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Address Line | 700 MICHIGAN AVE
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City | HOLLAND
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State | MI
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Zip | 49423-6944
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Country | US
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Telephone | 616-392-8507
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Fax | 616-392-8681
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Authorized Official
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Title or Position | PRESIDENT
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Name | MURALI C GINJUPALLI
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Credential |
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Telephone | 989-906-4232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5301005911
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License Number State | MI
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