Provider Demographics
NPI:1003100413
Name:YOUNG, JAMY LYNN (RPH)
Entity Type:Individual
Prefix:
First Name:JAMY
Middle Name:LYNN
Last Name:YOUNG
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6064 MARSHA SHARP FWY
Mailing Address - Street 2:TARGET PHARMACY T2190
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79407-3726
Mailing Address - Country:US
Mailing Address - Phone:806-788-3601
Mailing Address - Fax:806-788-3611
Practice Address - Street 1:6064 MARSHA SHARP FWY
Practice Address - Street 2:TARGET PHARMACY T2190
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79407-3726
Practice Address - Country:US
Practice Address - Phone:806-788-3601
Practice Address - Fax:806-788-3611
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-02
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35711183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist