Provider Demographics
NPI:1245524602
Name:LEE, EUNICE YOUNG (PHARMD)
Entity type:Individual
Prefix:
First Name:EUNICE
Middle Name:YOUNG
Last Name:LEE
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 1:7109 PIPERS RUN PL
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89084-3157
Mailing Address - Country:US
Mailing Address - Phone:702-580-3214
Mailing Address - Fax:702-933-2315
Practice Address - Street 1:8750 W CHARLESTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-5452
Practice Address - Country:US
Practice Address - Phone:702-933-2315
Practice Address - Fax:702-933-2315
Is Sole Proprietor?:No
Enumeration Date:2011-06-02
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV17635183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist