Dykstra Drug Store

LBN: Dykstra Drug Store
Dykstra Drug Store is an health care organization with primary practice located at 91 Douglas Ave , Holland MI 49424-2188. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. Dykstra Drug Store can be contacted via phone (616) 392-8130, or through Klaasen, Thomas D via phone (616) 392-8130.

Contact Information

Primary practice address
91 Douglas Ave Holland MI 49424-2188
Phone: (616) 392-8130
Fax: (616) 392-8025
Website:
Map and Directions
Authorized official contact:
Name: Klaasen, Thomas D RPH
Phone: (616) 392-8130

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X 5301001241 Michigan

Profile Details

NPI number 1922058908
LBN Legal business name Dykstra Drug Store
DBA Doing business as
Authorized official Klaasen, Thomas D RPH
Entity Organization
Organization subpart 1 No
Enumeration date May 11th, 2006
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922058908 NPPES
Michigan MEDICAID 4294122
Michigan MEDICAID 2328587
Michigan Other 2328587

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