Provider Demographics
NPI:1578614673
Name:YPC CORP
Entity Type:Organization
Organization Name:YPC CORP
Other - Org Name:VARIETY DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YOUSUF
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNNAN UR REHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-779-5951
Mailing Address - Street 1:50 PASSAIC ST
Mailing Address - Street 2:
Mailing Address - City:GARFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07026-3159
Mailing Address - Country:US
Mailing Address - Phone:973-779-5951
Mailing Address - Fax:973-473-5935
Practice Address - Street 1:50 PASSAIC ST
Practice Address - Street 2:
Practice Address - City:GARFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07026-3159
Practice Address - Country:US
Practice Address - Phone:973-779-5951
Practice Address - Fax:973-473-5935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-15
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RS006977003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8802246Medicaid
3109344OtherNCPDP PROVIDER IDENTIFICATION NUMBER
3109344OtherNCPDP PROVIDER IDENTIFICATION NUMBER