Provider Demographics
NPI:1952126211
Name:YURETICH, JOSEPH ALAN
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:ALAN
Last Name:YURETICH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:870 N 28TH ST APT 205
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-1729
Mailing Address - Country:US
Mailing Address - Phone:412-923-6730
Mailing Address - Fax:
Practice Address - Street 1:125 E 9TH ST
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-6019
Practice Address - Country:US
Practice Address - Phone:412-923-6730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-20
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP4538501835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist