Provider Demographics
NPI:1124337134
Name:YOUNG, JAY DEE (BS PHARMACY)
Entity type:Individual
Prefix:MR
First Name:JAY
Middle Name:DEE
Last Name:YOUNG
Suffix:
Gender:M
Credentials:BS PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 E COPPER AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93730-5402
Mailing Address - Country:US
Mailing Address - Phone:559-433-1290
Mailing Address - Fax:559-433-1296
Practice Address - Street 1:2020 E COPPER AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93730-5402
Practice Address - Country:US
Practice Address - Phone:559-433-1290
Practice Address - Fax:559-433-1296
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-26
Last Update Date:2010-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH30857183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist