Holder-Southern Drug Company Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

50-2293 Issued in OK

Legal business name

HOLDER-SOUTHERN DRUG COMPANY INC

Doing business as

Holder Drug

Practice address

513 Barnes Ave
Alva, OK 73717

Phone

(580) 327-3332

Fax

(580) 327-1848

NPI assigned

Oct 13, 2006

Last updated

Sep 21, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

John Todd HolderNPI 1861163255

Title

President

Phone

(580) 327-3332

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Holder Drug Doing business as

Medicare fee-for-service enrollment

Enrolled in OK2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare medical equipment & supply locations

Locations

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Todd Holder

  • Pharmacy Technician
  • Alva, OK
  • NPI 1861163255
  NPD Authorized official
• Melissa Elaine Fisher

  • Pharmacy Technician
  • Alva, OK
  • NPI 1427729896
  NPD
• Adam Jordan, DPH

  • Pharmacist
  • Alva, OK
  • NPI 1861083701
  NPD
• Abigail B.Nicole Reynolds

  • Pharmacist
  • Alva, OK
  • NPI 1003568106

  Community/Retail Pharmacy

  NPD
• Callie Diane Pray, PHARMD

  • Pharmacist
  • Alva, OK
  • NPI 1881255909
  NPD (past)
• Joshua Jameson Pray, PHARMD

  • Pharmacist
  • Alva, OK
  • NPI 1023614112
  NPD (past)
• Susan Kay Scott, DPH

  • Pharmacist
  • Alva, OK
  • NPI 1679179220
  NPD (past)
• Marisa Ashlee Tolson, PHARMD

  • Pharmacist
  • Alva, OK
  • NPI 1407108350
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600646400000",
    "number": "1396835013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 BARNES AVE",
            "city": "ALVA",
            "state": "OK",
            "postal_code": "737172229",
            "telephone_number": "580-327-3332",
            "fax_number": "580-327-1848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 BARNES AVE",
            "city": "ALVA",
            "state": "OK",
            "postal_code": "73717",
            "telephone_number": "580-327-3332",
            "fax_number": "580-327-1848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLDER-SOUTHERN DRUG COMPANY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A",
        "authorized_official_last_name": "HOLDER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "TODD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "580-327-3332"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OK",
            "license": "50-2293",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "OK",
            "license": "50-2293",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1002372301A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1002372301B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Holder Drug",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Grand Lake Mental Health Center, Inc. (GRAND Mental Health)
• John Thomas Gregg, M. D.
• Jerrad Hada, PT
• Lindsey Erin Head, P.A.-C
• Kohannah Hess, BS
• John Todd Holder
• Gwyneth Leigh Holderby, DNP
• Melissa Hook
• Human Performance Center 3 PLLC
• Megan A Isaacs

• Community/Retail Pharmacy in Alva, OK
• Providers in Alva, OK by specialty
• Community/Retail Pharmacy in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.