Provider Demographics
NPI:1881789394
Name:YOST PHARMACY INC
Entity type:Organization
Organization Name:YOST PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:YOST
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:513-398-5010
Mailing Address - Street 1:120 WEST MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-1799
Mailing Address - Country:US
Mailing Address - Phone:513-398-5010
Mailing Address - Fax:513-459-7013
Practice Address - Street 1:120 WEST MAIN ST
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-1799
Practice Address - Country:US
Practice Address - Phone:513-398-5010
Practice Address - Fax:513-459-7013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0149510001332B00000X
OH0201007003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000003373OtherANTHEM
OH9717800Medicaid
OH3615070OtherNABP
OH0149510001Medicare ID - Type Unspecified