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Contact Information

YOURX STORE INC
27 S MAIN STREET
MARENGO, OH43334
 Phone: 419-253-3831
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for YOURX STORE INC

NPI # 1689743320
LBN Legal business name YOURX STORE INC
Authorized official LARRY HILDEBRAND - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 11/07/2006
Last updated 01/25/2011 - About 15 years ago
Identifiers
OH License # 020086300
OH Medicaid 0288915
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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