Provider Demographics
NPI:1285061358
Name:YOUNG, AMELIA (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:AMELIA
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 CASCADE DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35633
Mailing Address - Country:US
Mailing Address - Phone:256-760-4828
Mailing Address - Fax:
Practice Address - Street 1:3401 WOODWARD AVE
Practice Address - Street 2:
Practice Address - City:MUSCLE SHOALS
Practice Address - State:AL
Practice Address - Zip Code:35661-3541
Practice Address - Country:US
Practice Address - Phone:256-381-0631
Practice Address - Fax:256-381-0636
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL15039183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL15039OtherALABAMA BOARD OF PHARMACY