Provider Demographics
NPI:1407456866
Name:YOUNG, DARLA DENISE
Entity Type:Individual
Prefix:
First Name:DARLA
Middle Name:DENISE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 SHORT RD
Mailing Address - Street 2:
Mailing Address - City:PEACH BOTTOM
Mailing Address - State:PA
Mailing Address - Zip Code:17563-9404
Mailing Address - Country:US
Mailing Address - Phone:410-241-8737
Mailing Address - Fax:
Practice Address - Street 1:800 COMMONS DR
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:PA
Practice Address - Zip Code:19363-1247
Practice Address - Country:US
Practice Address - Phone:484-702-7311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP440666183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist