Provider Demographics
NPI:1275944241
Name:GENTRY HEALTH SERVICES INC
Entity Type:Organization
Organization Name:GENTRY HEALTH SERVICES INC
Other - Org Name:DISCOUNT DRUG MART
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-725-2340
Mailing Address - Street 1:1090 ENTERPRISE DR
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-1328
Mailing Address - Country:US
Mailing Address - Phone:330-661-6061
Mailing Address - Fax:844-329-2447
Practice Address - Street 1:1090 ENTERPRISE DR
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-1328
Practice Address - Country:US
Practice Address - Phone:330-661-6061
Practice Address - Fax:844-329-2447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-13
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0224018003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2145731OtherPK