Provider Demographics
NPI:1164745089
Name:YUCHASZ, JULIE (RPH)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:YUCHASZ
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 1:321 BRIAN CT
Mailing Address - Street 2:
Mailing Address - City:ORTONVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48462-8896
Mailing Address - Country:US
Mailing Address - Phone:248-627-8072
Mailing Address - Fax:
Practice Address - Street 1:901 S STATE RD
Practice Address - Street 2:
Practice Address - City:DAVISON
Practice Address - State:MI
Practice Address - Zip Code:48423-1721
Practice Address - Country:US
Practice Address - Phone:810-653-4020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-05
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302027765183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist