Healthcare Provider Details

I. General information

NPI: 1417097403
Provider Name (Legal Business Name): DEIRDRE A YOUNGER R.PH.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BLDG 140 CAMPUS DRIVE UNIVERSITY OF MARYLAND UNIVERSITY HEALTH CENTER
COLLEGE PARK MD
20742
US

IV. Provider business mailing address

BLDG 140 CAMPUS DRIVE UNIVERSITY OF MARYLAND UNIVERSITY HEALTH CENTER
COLLEGE PARK MD
20742
US

V. Phone/Fax

Practice location:
  • Phone: 301-314-9686
  • Fax: 301-314-3677
Mailing address:
  • Phone: 301-314-9686
  • Fax: 301-314-3677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number09985
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: