MEDICARE: YN PHARMACY LLC

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	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1255705216
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YN PHARMACY LLC

Provider Business Mailing Address
First Line	:	801-21 WASHINGTON AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19147-4716
Country	:	US
Telephone Number	:	484-557-1671
Fax Number	:

Provider Business Practice Location Address
First Line	:	801-21 WASHINGTON AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19147-4716
Country	:	US
Telephone Number	:	484-557-1671
Fax Number	:

Authorized Official
Title or Position	:	MANAGER/OWNER
Name	:	ALEX N LUONG
Credential	:	RPH
Telephone Number	:	484-557-1671

Provider Enumeration Date	:	11/13/2015
Last Update Date	:	12/02/2015

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Directions to “YN PHARMACY LLC ” Practice Location

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