Provider Demographics
NPI:1467471698
Name:RJ PROFESSIONALS, INC.
Entity Type:Organization
Organization Name:RJ PROFESSIONALS, INC.
Other - Org Name:YOUNG'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEANETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:610-866-4552
Mailing Address - Street 1:3708 FREEMANSBURG AVE
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18020-6512
Mailing Address - Country:US
Mailing Address - Phone:610-866-4552
Mailing Address - Fax:610-866-2989
Practice Address - Street 1:3708 FREEMANSBURG AVE
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-6512
Practice Address - Country:US
Practice Address - Phone:610-866-4552
Practice Address - Fax:610-866-2989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP413221L3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA3935953OtherNABP
PA0015817620002Medicaid
1099280001Medicare NSC