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NPI Code Detail

MEDICARE: MR. JAY DEE YOUNG B.S. PHARMACY

MEDICARE: MR. JAY DEE YOUNG B.S. PHARMACY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistRPH30857CA

General Provider Information

NPI Number : 1124337134
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JAY DEE YOUNG B.S. PHARMACY
Provider Business Mailing Address
First Line : 2020 E COPPER AVE
Second Line :
City : FRESNO
State : CA
Zip : 93730-5402
Country : US
Telephone Number : 559-433-1290
Fax Number : 559-433-1296
Provider Business Practice Location Address
First Line : 2020 E COPPER AVE
Second Line :
City : FRESNO
State : CA
Zip : 93730-5402
Country : US
Telephone Number : 559-433-1290
Fax Number : 559-433-1296
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2010
Last Update Date : 09/26/2010

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