MEDICARE: JIM YANG

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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	03441862	OH

General Provider Information

NPI Number	:	1184358822
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JIM YANG

Provider Business Mailing Address
First Line	:	3609 WARSAW AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45205-1721
Country	:	US
Telephone Number	:	513-374-8782
Fax Number	:

Provider Business Practice Location Address
First Line	:	3609 WARSAW AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45205-1721
Country	:	US
Telephone Number	:	513-598-7890
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2022
Last Update Date	:	06/10/2026

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Directions to “ JIM YANG ” Practice Location

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