Healthcare Provider Details

I. General information

NPI: 1578078135
Provider Name (Legal Business Name): YING-CHU LIU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2017
Last Update Date: 12/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 W NORTH ST
SPRINGFIELD OH
45504-2607
US

IV. Provider business mailing address

1131 SCANLON LN
SPRINGFIELD OH
45503-6666
US

V. Phone/Fax

Practice location:
  • Phone: 937-324-5796
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03233900
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: