Provider Demographics
NPI:1134127855
Name:YOUNGS PHARMACY INC
Entity Type:Organization
Organization Name:YOUNGS PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:H
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:215-546-4929
Mailing Address - Street 1:1306 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-1823
Mailing Address - Country:US
Mailing Address - Phone:215-546-4929
Mailing Address - Fax:215-546-8606
Practice Address - Street 1:1306 SOUTH ST
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19147-1823
Practice Address - Country:US
Practice Address - Phone:215-546-4929
Practice Address - Fax:215-546-8606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP025115L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0823450001Medicare ID - Type Unspecified