Provider Demographics
NPI:1760084545
Name:YINGLING, JUSTIN (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:
Last Name:YINGLING
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 E NELSON ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24450-2731
Mailing Address - Country:US
Mailing Address - Phone:540-463-7126
Mailing Address - Fax:540-463-1612
Practice Address - Street 1:506 E NELSON ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:VA
Practice Address - Zip Code:24450-2731
Practice Address - Country:US
Practice Address - Phone:814-327-0124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202214556183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist