Provider Demographics
NPI:1255705216
Name:YN PHARMACY LLC
Entity type:Organization
Organization Name:YN PHARMACY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:N
Authorized Official - Last Name:LUONG
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:484-557-1671
Mailing Address - Street 1:801-21 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-4716
Mailing Address - Country:US
Mailing Address - Phone:484-557-1671
Mailing Address - Fax:
Practice Address - Street 1:801-21 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-4716
Practice Address - Country:US
Practice Address - Phone:484-557-1671
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-13
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy