Provider Demographics
NPI:1508628793
Name:VEGAS YOUN PHARMACY LLC
Entity Type:Organization
Organization Name:VEGAS YOUN PHARMACY LLC
Other - Org Name:VEGAS YOUN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST ( OWNER)
Authorized Official - Prefix:
Authorized Official - First Name:CHANGPA
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-540-9878
Mailing Address - Street 1:8038 PASSION CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-1898
Mailing Address - Country:US
Mailing Address - Phone:725-251-3302
Mailing Address - Fax:725-251-3534
Practice Address - Street 1:6126 W FLAMINGO RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-2280
Practice Address - Country:US
Practice Address - Phone:725-251-3302
Practice Address - Fax:725-251-3534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-24
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy