=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477144616
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | GEENA YOUNG PHARM.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/31/2021
-----------------------------------------------------
Last Update Date | 01/31/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5414 ROTARY AVE
-----------------------------------------------------
City | NEW MARKET
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21774
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-865-0019
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7904 HOPE VALLEY CT
-----------------------------------------------------
City | ADAMSTOWN
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21710
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-503-4555
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | PH3281
-----------------------------------------------------
License Number State | DC
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 0202012819
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 14329
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------