Provider Demographics
NPI:1558651190
Name:CHERKAOUI, YOUNES
Entity Type:Individual
Prefix:
First Name:YOUNES
Middle Name:
Last Name:CHERKAOUI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24210-2423
Mailing Address - Country:US
Mailing Address - Phone:276-628-3511
Mailing Address - Fax:
Practice Address - Street 1:711 W MAIN ST
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210-2423
Practice Address - Country:US
Practice Address - Phone:276-628-3511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-16
Last Update Date:2011-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202204754183500000X
TN0000028259183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist