Healthcare Provider Details

I. General information

NPI: 1295560001
Provider Name (Legal Business Name): MICHAEL JAMES YEAGER PHARMD, RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2024
Last Update Date: 09/03/2024
Certification Date: 09/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1236 LONG RUN RD
WHITE OAK PA
15131-2035
US

IV. Provider business mailing address

338 E 9TH AVE APT 405
HOMESTEAD PA
15120-1698
US

V. Phone/Fax

Practice location:
  • Phone: 412-678-2755
  • Fax: 412-678-0191
Mailing address:
  • Phone: 215-704-0386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP458728
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: