Provider Demographics
NPI:1205900693
Name:OH, YOUNG R (PHARMD)
Entity type:Individual
Prefix:MISS
First Name:YOUNG
Middle Name:R
Last Name:OH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MISS
Other - First Name:EUNICE
Other - Middle Name:Y
Other - Last Name:OH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:697 LOUISIANA RD
Mailing Address - Street 2:7 MDSS/SGSD DYESS AFB
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79607-1141
Mailing Address - Country:US
Mailing Address - Phone:325-696-4677
Mailing Address - Fax:325-696-3359
Practice Address - Street 1:697 LOUISIANA RD
Practice Address - Street 2:7 MDSS/SGSD DYESS AFB
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79607-1141
Practice Address - Country:US
Practice Address - Phone:325-696-4677
Practice Address - Fax:325-696-3359
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA500101835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy