Provider Demographics
NPI:1407956493
Name:YODER'S MEATS, INC.
Entity Type:Organization
Organization Name:YODER'S MEATS, INC.
Other - Org Name:YODER'S MARKET PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:YODER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-354-4748
Mailing Address - Street 1:14 S TOWER RD
Mailing Address - Street 2:YODERS MARKET PHARMACY
Mailing Address - City:NEW HOLLAND
Mailing Address - State:PA
Mailing Address - Zip Code:17557
Mailing Address - Country:US
Mailing Address - Phone:717-354-4999
Mailing Address - Fax:717-354-3027
Practice Address - Street 1:14 S TOWER RD
Practice Address - Street 2:YODERS MARKET PHARMACY
Practice Address - City:NEW HOLLAND
Practice Address - State:PA
Practice Address - Zip Code:17557
Practice Address - Country:US
Practice Address - Phone:717-354-4999
Practice Address - Fax:717-354-3027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP040806L183500000X
333600000X
PAPP415234L3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail PharmacyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016170790002Medicaid
PAPP415234LOtherPA PERMIT DEPT OF STATE
PA1617079Medicaid
3972432OtherOTHER ID NUMBER
1257790001Medicare NSC