Provider Demographics
NPI:1265755458
Name:YANKOVICH, DENISE ANNE (RPH)
Entity type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:ANNE
Last Name:YANKOVICH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54809 ALEXIS CT
Mailing Address - Street 2:
Mailing Address - City:SHELBY TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48316-1360
Mailing Address - Country:US
Mailing Address - Phone:248-601-2928
Mailing Address - Fax:
Practice Address - Street 1:1100 S ROCHESTER RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-3114
Practice Address - Country:US
Practice Address - Phone:248-652-9480
Practice Address - Fax:248-601-0396
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-02
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302024221183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist