Provider Demographics
NPI:1831795558
Name:YOUNGS APOTHECARY INC
Entity type:Organization
Organization Name:YOUNGS APOTHECARY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:570-996-0440
Mailing Address - Street 1:230 W TIOGA ST STE 3
Mailing Address - Street 2:
Mailing Address - City:TUNKHANNOCK
Mailing Address - State:PA
Mailing Address - Zip Code:18657-6668
Mailing Address - Country:US
Mailing Address - Phone:570-996-0440
Mailing Address - Fax:570-996-0217
Practice Address - Street 1:230 W TIOGA ST STE 3
Practice Address - Street 2:
Practice Address - City:TUNKHANNOCK
Practice Address - State:PA
Practice Address - Zip Code:18657-6668
Practice Address - Country:US
Practice Address - Phone:570-996-0440
Practice Address - Fax:570-996-0217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPP482108OtherPA BOARD OF PHARMACY LICENSE