Healthcare Provider Details

I. General information

NPI: 1720200413
Provider Name (Legal Business Name): MRS. BARBARA S YOUNG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 ELM ST
LUDLOW KY
41016-1450
US

IV. Provider business mailing address

334 OAK ST
LUDLOW KY
41016-1417
US

V. Phone/Fax

Practice location:
  • Phone: 859-261-2210
  • Fax: 859-292-2873
Mailing address:
  • Phone: 859-431-3298
  • Fax: 859-292-2873

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: