Healthcare Provider Details

I. General information

NPI: 1831795558
Provider Name (Legal Business Name): YOUNGS APOTHECARY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2020
Last Update Date: 12/08/2020
Certification Date: 12/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 W TIOGA ST STE 3
TUNKHANNOCK PA
18657-6668
US

IV. Provider business mailing address

230 W TIOGA ST STE 3
TUNKHANNOCK PA
18657-6668
US

V. Phone/Fax

Practice location:
  • Phone: 570-996-0440
  • Fax: 570-996-0217
Mailing address:
  • Phone: 570-996-0440
  • Fax: 570-996-0217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierPP482108
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerPA BOARD OF PHARMACY LICENSE

VIII. Authorized Official

Name: COURTNEY YOUNG
Title or Position: OWNER
Credential: PHARMD
Phone: 570-996-0440