NPIMap

Organization Active NPI

Holt Pharmacy Services, LLC

  • Community/Retail Pharmacy
  • Holt, MI
National Provider Identifier
1831104447
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5301007439 Issued in MI
Legal business name
HOLT PHARMACY SERVICES, LLC
Practice address
2018 Cedar St Ste a
Holt, MI 48842-1400
Phone
(517) 694-9707
Fax
(517) 694-9713
NPI assigned
Jul 30, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Mr. Jayson B Bulmahn, RPHNPI 1124121249
Title
Managing Member
Phone
(716) 471-8067

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 5301007439 MI Primary

Addresses

Primary practice location

2018 Cedar St Ste a
Holt, MI 48842-1400

Mailing address

2018 Cedar St Ste a
Holt, MI 48842-1400
Phone (517) 694-9707

Other identifiers 2

IdentifierTypeStateIssuer
2363062MedicaidMI
2363062OtherNCPDP

National Provider Directory

National Provider Directory

Locations

2018 Cedar St
Ste A
Holt, MI 48842
Phone (517) 694-9707

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1831104447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2018 CEDAR ST STE A",
            "city": "HOLT",
            "state": "MI",
            "postal_code": "488421400",
            "telephone_number": "517-694-9707",
            "fax_number": "517-694-9713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2018 CEDAR ST STE A",
            "city": "HOLT",
            "state": "MI",
            "postal_code": "488421400",
            "telephone_number": "517-694-9707",
            "fax_number": "517-694-9713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLT PHARMACY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "BULMAHN",
        "authorized_official_first_name": "JAYSON",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "716-471-8067",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301007439",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2363062",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2363062",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holt, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.