Healthcare Provider Details

I. General information

NPI: 1497680961
Provider Name (Legal Business Name): THRIVERX HEALTH PHARMACY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

652 W CENTRAL AVE STE 70
DELAWARE OH
43015-1440
US

IV. Provider business mailing address

4521 COUNTY ROAD 213
MARENGO OH
43334-9602
US

V. Phone/Fax

Practice location:
  • Phone: 815-757-5565
  • Fax:
Mailing address:
  • Phone: 815-757-5565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: LARECIA SEIBERT
Title or Position: OWNER
Credential: PHARMD
Phone: 815-757-5565