Healthcare Provider Details

I. General information

NPI: 1700288289
Provider Name (Legal Business Name): YIN LAI PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2014
Last Update Date: 09/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 W APACHE TRL
APACHE JUNCTION AZ
85120-3954
US

IV. Provider business mailing address

325 W APACHE TRL
APACHE JUNCTION AZ
85120-3954
US

V. Phone/Fax

Practice location:
  • Phone: 480-983-1129
  • Fax:
Mailing address:
  • Phone: 480-983-1129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS020790
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: