Provider Demographics
NPI:1073781779
Name:YOUNG, ALAN M (RPH)
Entity Type:Individual
Prefix:MR
First Name:ALAN
Middle Name:M
Last Name:YOUNG
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 SEEDLING DR
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:PA
Mailing Address - Zip Code:18966-2840
Mailing Address - Country:US
Mailing Address - Phone:215-968-3699
Mailing Address - Fax:
Practice Address - Street 1:4160 MONUMENT RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131-1726
Practice Address - Country:US
Practice Address - Phone:215-879-8830
Practice Address - Fax:215-879-7466
Is Sole Proprietor?:No
Enumeration Date:2008-02-15
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP033794L183500000X
NJ28RI01968800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP033794LOtherRPH STATE LICENSE NUMBER
NJ28RI01968800OtherRPH STATE LICENSE NUMBER