Healthcare Provider Details
I. General information
NPI: 1982999660
Provider Name (Legal Business Name): GEORGE CHALMERS YOUNG III PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/10/2011
Last Update Date: 06/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14978 RANKIN AVE
DUNLAP TN
37327-7006
US
IV. Provider business mailing address
8246 MILL RACE DR
OOLTEWAH TN
37363-6844
US
V. Phone/Fax
- Phone: 423-949-4049
- Fax: 423-949-6850
- Phone: 423-238-3470
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | 9888 |
| License Number State | TN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: