Provider Demographics
NPI:1720562309
Name:YE, LUIS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:
Last Name:YE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4842 STEPHANIE KAY DR S APT 106
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-6378
Mailing Address - Country:US
Mailing Address - Phone:614-893-4161
Mailing Address - Fax:
Practice Address - Street 1:1685 WESTBELT DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-3809
Practice Address - Country:US
Practice Address - Phone:908-389-1818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-19
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60860238183500000X
OH03438557183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist