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General NPI Number Information
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NPI Number | 1104315597
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Entity Type | Organization
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Legal Business Name | YOURX PHARMACY LLC
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Dates
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Enumeration Date | 05/01/2018
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Last Update Date | 08/02/2023
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Provider Practice Location Address
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Address Line | 33136 RYAN RD
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City | STERLING HEIGHTS
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State | MI
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Zip | 48310-6462
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Country | US
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Telephone | 586-393-5232
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Fax | 586-393-5250
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Provider Business Mailing Address
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Address Line | 33136 RYAN RD
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City | STERLING HEIGHTS
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State | MI
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Zip | 48310-6462
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Country | US
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Telephone | 586-393-5232
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Fax | 586-393-5250
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Authorized Official
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Title or Position | OWNER/PIC
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Name | JAWAN DANHO
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Credential | PHARMD
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Telephone | 586-393-5232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5301011388
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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