Healthcare Provider Details

I. General information

NPI: 1306920566
Provider Name (Legal Business Name): MARILYN JEAN YURCHICK RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 INDEPENDENCE STREET BOX 314
PERRYOPOLIS PA
15473
US

IV. Provider business mailing address

13 VANBUREN STREET PO BOX 242
COKEBURG PA
15324
US

V. Phone/Fax

Practice location:
  • Phone: 724-736-4422
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP028239L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: