Healthcare Provider Details

I. General information

NPI: 1497078323
Provider Name (Legal Business Name): STEPHANIE YEUNG PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2010
Last Update Date: 03/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 WOODRUFF RD
SIMPSONVILLE SC
29681-4804
US

IV. Provider business mailing address

253 RAVEN FALLS LN
SIMPSONVILLE SC
29681-8166
US

V. Phone/Fax

Practice location:
  • Phone: 864-234-3866
  • Fax:
Mailing address:
  • Phone: 570-574-9507
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number35408
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP443792
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: