MEDICARE: BRONSON YOUNG PHARM D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	11784337-1721	UT

General Provider Information

NPI Number	:	1417641598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRONSON YOUNG PHARM D.

Provider Business Mailing Address
First Line	:	2380 N 400 E STE E
Second Line	:
City	:	LOGAN
State	:	UT
Zip	:	84341-1767
Country	:	US
Telephone Number	:	435-787-1212
Fax Number	:

Provider Business Practice Location Address
First Line	:	2380 N 400 E STE E
Second Line	:
City	:	LOGAN
State	:	UT
Zip	:	84341-1767
Country	:	US
Telephone Number	:	435-787-1212
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2023
Last Update Date	:	06/02/2023

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Directions to “ BRONSON YOUNG PHARM D.” Practice Location

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