Healthcare Provider Details

I. General information

NPI: 1518880160
Provider Name (Legal Business Name): RICKIE YANG PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 E VETERANS ST
TOMAH WI
54660-3105
US

IV. Provider business mailing address

3944 TROY ST
WAUSAU WI
54403-2257
US

V. Phone/Fax

Practice location:
  • Phone: 608-372-3971
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2358440
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: