Hollywood Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

00526 Issued in OR

Legal business name

HOLLYWOOD PHARMACY INC

Practice address

1890 Capitol St NE
Salem, OR 97301-7859

Phone

(503) 364-4436

Fax

(503) 364-5103

NPI assigned

Dec 1, 2006

Organization subpart

No

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

Authorized official

Name

Robert Kasprzyk, RPH

Title

Owner

Phone

(503) 364-4436

Specialties & licenses 4

Addresses

Other identifiers 4

Other names 1

• MEDICINE SHOPPE Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Kasprzyk Enterprises, Inc.

  • Community/Retail Pharmacy
  • Dallas, OR
  • NPI 1457396731

  Member Of

  NPD member

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Kasprzyk Enterprises, Inc.

  • Community/Retail Pharmacy
  • Dallas, OR
  • NPI 1457396731

  Member Of

  NPD member

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1982772786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1890 CAPITOL ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973017859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 CAPITOL ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973017859",
            "telephone_number": "503-364-4436",
            "fax_number": "503-364-5103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLYWOOD PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "KASPRZYK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-364-4436",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OR",
            "license": "00526",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131177",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "230545",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3804627",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DME",
            "identifier": "292935",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDICINE SHOPPE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Fallon Holloway
• William David Holloway, MD
• Holly a Chamberlain DDS LLC
• Hollywood Pharmacy Inc
• Hollywood Pharmacy Inc
• Clarence T Holman III, L. AC.
• Kimberly Anne Holman, MT
• Michael Foster Holman, PHARM.D.
• Cynthia Holmes
• Kathy Colene Holmes, QMHA

• Community/Retail Pharmacy in Salem, OR
• Providers in Salem, OR by specialty
• Community/Retail Pharmacy in Oregon

• 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.