Hys Health Mart Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

RTP.022177550 Issued in OH

Legal business name

HYS HEALTH MART INC

Practice address

403 Cleveland St
Elyria, OH 44035-6143

Phone

(440) 366-1035

Fax

(440) 366-0028

NPI assigned

Dec 5, 2011

Organization subpart

No

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

Authorized official

Name

Sam Salouha, RPH

Title

President

Phone

(440) 366-1035

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• MEDICINE CENTER PHARMACY Doing business as

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

{
    "created_epoch": "1323043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386288000000",
    "number": "1134497175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 CLEVELAND ST",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440356143",
            "telephone_number": "440-366-1035",
            "fax_number": "440-366-0028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 CLEVELAND ST",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440356143",
            "telephone_number": "440-366-1035",
            "fax_number": "440-366-0028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HYS HEALTH MART INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-05",
        "last_updated": "2013-12-06",
        "status": "A",
        "authorized_official_last_name": "SALOUHA",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-366-1035",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "RTP.022177550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0063260",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2132941",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDICINE CENTER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Elyria, OH
• Providers in Elyria, OH by specialty
• Community/Retail Pharmacy in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2013; 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.