Provider Demographics
NPI:1952857120
Name:YU, XUEJING (PHARMD)
Entity Type:Individual
Prefix:
First Name:XUEJING
Middle Name:
Last Name:YU
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E WASHINGTON JACKSON RD
Mailing Address - Street 2:
Mailing Address - City:EATON
Mailing Address - State:OH
Mailing Address - Zip Code:45320-9729
Mailing Address - Country:US
Mailing Address - Phone:937-456-7720
Mailing Address - Fax:
Practice Address - Street 1:100 E WASHINGTON JACKSON RD
Practice Address - Street 2:
Practice Address - City:EATON
Practice Address - State:OH
Practice Address - Zip Code:45320-9729
Practice Address - Country:US
Practice Address - Phone:937-456-7720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-28
Last Update Date:2020-12-08
Deactivation Date:2018-10-10
Deactivation Code:
Reactivation Date:2020-12-08
Provider Licenses
StateLicense IDTaxonomies
OH03135606-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist