Provider Demographics
NPI:1174626295
Name:YORK DISCUNT DRUGS INC
Entity type:Organization
Organization Name:YORK DISCUNT DRUGS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST-IN-CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:FORREST
Authorized Official - Middle Name:
Authorized Official - Last Name:PACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-732-2503
Mailing Address - Street 1:PO BOX 849
Mailing Address - Street 2:
Mailing Address - City:OWENSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45160-0849
Mailing Address - Country:US
Mailing Address - Phone:513-732-2503
Mailing Address - Fax:513-732-5591
Practice Address - Street 1:220 W MAIN ST
Practice Address - Street 2:
Practice Address - City:OWENSVILLE
Practice Address - State:OH
Practice Address - Zip Code:45160
Practice Address - Country:US
Practice Address - Phone:513-732-2503
Practice Address - Fax:513-732-5591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
OH0201790003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2075771OtherPK
OH0471805Medicaid
4221250001Medicare NSC