Provider Demographics
NPI:1881758464
Name:YOUMANS, DEAN BRYANT (RPH)
Entity type:Individual
Prefix:MR
First Name:DEAN
Middle Name:BRYANT
Last Name:YOUMANS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:923 WEST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:LAURENS
Mailing Address - State:SC
Mailing Address - Zip Code:29360-2605
Mailing Address - Country:US
Mailing Address - Phone:864-984-6023
Mailing Address - Fax:864-681-1124
Practice Address - Street 1:923 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:LAURENS
Practice Address - State:SC
Practice Address - Zip Code:29360-2605
Practice Address - Country:US
Practice Address - Phone:864-984-1544
Practice Address - Fax:864-984-6023
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2017-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC50001139183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC711394Medicaid
SC0556650001Medicare ID - Type Unspecified