Provider Demographics
NPI:1124113683
Name:YOUNG, DENNIS CARY (RPH)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:CARY
Last Name:YOUNG
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:DENNIS
Other - Middle Name:CARY
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMACIST
Mailing Address - Street 1:6 FIRST STREET
Mailing Address - Street 2:
Mailing Address - City:HAMLIN
Mailing Address - State:WV
Mailing Address - Zip Code:25523
Mailing Address - Country:US
Mailing Address - Phone:304-824-2667
Mailing Address - Fax:
Practice Address - Street 1:6 FIRST STREET
Practice Address - Street 2:
Practice Address - City:HAMLIN
Practice Address - State:WV
Practice Address - Zip Code:25523
Practice Address - Country:US
Practice Address - Phone:304-824-2667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0004826183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist