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Holland Drug Co., Inc.

Details

Name: Holland Drug Co., Inc.
Jurisdiction: Alabama
Legal type: Domestic Corporation
Status: Dissolved
Date of registration: 11 Dec 2000 (24 years ago)
Date of dissolution: 13 Mar 2017
Entity Number: 000-213-668
Register Number: 000213668
County: Cullman
Place of Formation: Cullman County
Principal Address: CULLMAN, AL
Registered Office Street Address: 1704 CHEROKEE AVE SWCULLMAN, AL 35055
Registered Office Street Address ZIP Code: 35055
Authorized Capital: $1,000
Paid Share Capital: $1,000

Activities OWN/OPERATE A PHARMACEUTICAL BUSINESS

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1790883726 2006-09-21 2009-11-13 1704 CHEROKEE AVE SW, CULLMAN, AL, 350555333, US 1704 CHEROKEE AVE SW, CULLMAN, AL, 350555333, US

Contacts
Phone +1 256-734-1935
Fax 2567399346

Authorized person
Name KEVIN HOLLAND
Role OWNER PRESIDENT
Phone 2567341935

Taxonomy
Taxonomy Code 333600000X - Pharmacy
Is Primary No
Taxonomy Code 3336C0003X - Community/Retail Pharmacy
License Number 111843
State AL
Is Primary Yes

Other Provider Identifiers
Issuer NCPDP PROVIDER IDENTIFICATION NUMBER
Number 0114431
Issuer MEDICAID
Number 100003213
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
HOLLAND DRUG CO., INC. 401(K) PLAN 2013 631263126 2014-07-07 HOLLAND DRUG CO., INC. 7
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 446110
Sponsor’s telephone number 2567341935
Plan sponsor’s address 1704 CHEROKEE AVENUE SW, CULLMAN, AL, 35055

Signature of
Role Plan administrator
Date 2014-07-07
Name of individual signing KEVIN HOLLAND
HOLLAND DRUG CO., INC. 401(K) PLAN 2013 631263126 2014-11-14 HOLLAND DRUG CO., INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 446110
Sponsor’s telephone number 2567341935
Plan sponsor’s address 1704 CHEROKEE AVENUE SW, CULLMAN, AL, 35055

Signature of
Role Plan administrator
Date 2014-11-14
Name of individual signing KEVIN HOLLAND
HOLLAND DRUG CO., INC. 401(K) PLAN 2013 631263126 2014-07-24 HOLLAND DRUG CO., INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 446110
Sponsor’s telephone number 2567341935
Plan sponsor’s address 1704 CHEROKEE AVENUE SW, CULLMAN, AL, 35055

Signature of
Role Plan administrator
Date 2014-07-24
Name of individual signing KEVIN HOLLAND
HOLLAND DRUG CO., INC. 401(K) PLAN 2012 631263126 2013-05-06 HOLLAND DRUG CO., INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 446110
Sponsor’s telephone number 2567341935
Plan sponsor’s address 1704 CHEROKEE AVENUE SW, CULLMAN, AL, 35055

Signature of
Role Plan administrator
Date 2013-05-06
Name of individual signing KEVIN HOLLAND
HOLLAND DRUG CO., INC. 401(K) PLAN 2011 631263126 2012-07-25 HOLLAND DRUG CO., INC. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 446110
Sponsor’s telephone number 2567341935
Plan sponsor’s address 1704 CHEROKEE AVENUE SW, CULLMAN, AL, 35055

Plan administrator’s name and address
Administrator’s EIN 631263126
Plan administrator’s name HOLLAND DRUG CO., INC.
Plan administrator’s address 1704 CHEROKEE AVENUE SW, CULLMAN, AL, 35055
Administrator’s telephone number 2567341935

Signature of
Role Plan administrator
Date 2012-07-25
Name of individual signing KEVIN HOLLAND
HOLLAND DRUG CO., INC. 401(K) PLAN 2010 631263126 2011-09-26 HOLLAND DRUG CO., INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 446110
Sponsor’s telephone number 2567341935
Plan sponsor’s address 1704 CHEROKEE AVENUE SW, CULLMAN, AL, 35055

Plan administrator’s name and address
Administrator’s EIN 631263126
Plan administrator’s name HOLLAND DRUG CO., INC.
Plan administrator’s address 1704 CHEROKEE AVENUE SW, CULLMAN, AL, 35055
Administrator’s telephone number 2567341935

Signature of
Role Plan administrator
Date 2011-09-26
Name of individual signing KEVIN HOLLAND
HOLLAND DRUG CO., INC. 401(K) PLAN 2009 631263126 2010-10-15 HOLLAND DRUG CO., INC. 6
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 446110
Sponsor’s telephone number 2567341935
Plan sponsor’s address 1704 CHEROKEE AVENUE SW, CULLMAN, AL, 35055

Plan administrator’s name and address
Administrator’s EIN 631263126
Plan administrator’s name HOLLAND DRUG CO., INC.
Plan administrator’s address 1704 CHEROKEE AVENUE SW, CULLMAN, AL, 35055
Administrator’s telephone number 2567341935
HOLLAND DRUG CO., INC. 401(K) PLAN 2009 631263126 2010-10-15 HOLLAND DRUG CO., INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 446110
Sponsor’s telephone number 2567341935
Plan sponsor’s address 1704 CHEROKEE AVENUE SW, CULLMAN, AL, 35055

Plan administrator’s name and address
Administrator’s EIN 631263126
Plan administrator’s name HOLLAND DRUG CO., INC.
Plan administrator’s address 1704 CHEROKEE AVENUE SW, CULLMAN, AL, 35055
Administrator’s telephone number 2567341935

Signature of
Role Plan administrator
Date 2010-10-15
Name of individual signing FRANK HARRISON

Agent

Name Role
HOLLAND, KEVIN GRANT Agent

Incorporator

Name Role
HOLLAND, KEVIN GRANT Incorporator

Related by officers

No related officers

Related by address

CULLMAN, AL

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1704 CHEROKEE AVE SWCULLMAN, AL 35055

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Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State

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