NPIMap

Organization Active NPI

Yourx Store Inc

  • Pharmacy
  • Marengo, OH
National Provider Identifier
1689743320
Registry record updated Jan 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
020086300 Issued in OH
Legal business name
YOURX STORE INC
Practice address
27 S Main Street
Marengo, OH 43334
Phone
(419) 253-3831
NPI assigned
Nov 7, 2006
Last updated
Jan 25, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2011

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

Authorized official

Name
Larry HildebrandNPI 1457489775
Title
Owner
Phone
(419) 253-3831

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 020086300 OH Primary

Addresses

Primary practice location

27 S Main Street
Marengo, OH 43334

Mailing address

PO Box 47
Marengo, OH 43334-0047
Phone (419) 253-3831

Other identifiers 1

IdentifierTypeStateIssuer
0288915MedicaidOH

National Provider Directory

National Provider Directory

Locations

27 S Main St
Marengo, OH 43334
Phone (419) 253-3831

Practitioners & affiliated clinicians

Practitioners 2

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": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295913600000",
    "number": "1689743320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 47",
            "city": "MARENGO",
            "state": "OH",
            "postal_code": "433340047",
            "telephone_number": "419-253-3831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 S MAIN STREET",
            "city": "MARENGO",
            "state": "OH",
            "postal_code": "43334",
            "telephone_number": "419-253-3831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOURX STORE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2011-01-25",
        "status": "A",
        "authorized_official_last_name": "HILDEBRAND",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-253-3831"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "OH",
            "license": "020086300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0288915",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marengo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2011; 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.