MEDICARE: YOUNGS PHARMACY INC

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
1	183500000X	Pharmacist	RP025115L	PA

General Provider Information

NPI Number	:	1134127855
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YOUNGS PHARMACY INC

Provider Business Mailing Address
First Line	:	1306 SOUTH ST
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19147-1823
Country	:	US
Telephone Number	:	215-546-4929
Fax Number	:	215-546-8606

Provider Business Practice Location Address
First Line	:	1306 SOUTH ST
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19147-1823
Country	:	US
Telephone Number	:	215-546-4929
Fax Number	:	215-546-8606

Authorized Official
Title or Position	:	PRES
Name	:	MR. LARRY H YOUNG
Credential	:	RPH
Telephone Number	:	215-546-4929

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	08/22/2020

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