Organization
HYS HEALTH MART INC
Active
Other names
MEDICINE CENTER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SAM SALOUHA RPH (PRESIDENT)
(440) 366-1035
Entity
Organization
Contact information
Practice address
403 CLEVELAND ST, ELYRIA, OH 44035-6143
(440) 366-1035
(440) 366-0028
Mailing address
403 CLEVELAND ST, ELYRIA, OH 44035-6143
(440) 366-1035
(440) 366-0028
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
RTP.022177550
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0063260
—
OH
01
—
2132941
PK
—
Enumeration date
12/05/2011
Last updated
12/06/2013
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