Provider Demographics
NPI:1477018919
Name:YINGER PHARMACY SHOPPE INC
Entity Type:Organization
Organization Name:YINGER PHARMACY SHOPPE INC
Other - Org Name:YINGER PHARMACY SHOPPE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PIC
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:NAGEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:734-243-5451
Mailing Address - Street 1:1704 S CUSTER RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48161-1622
Mailing Address - Country:US
Mailing Address - Phone:734-243-5451
Mailing Address - Fax:734-243-4354
Practice Address - Street 1:1704 S CUSTER RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48161-1622
Practice Address - Country:US
Practice Address - Phone:734-243-5451
Practice Address - Fax:734-243-4354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-08
Last Update Date:2024-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2354823Medicaid