Provider Demographics
NPI:1538450168
Name:YOUNG, AMANDA SUSANNE (PHARM D)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:SUSANNE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 39
Mailing Address - Street 2:
Mailing Address - City:INEZ
Mailing Address - State:KY
Mailing Address - Zip Code:41224-0039
Mailing Address - Country:US
Mailing Address - Phone:859-536-5578
Mailing Address - Fax:606-395-5480
Practice Address - Street 1:126 TURNER ST
Practice Address - Street 2:
Practice Address - City:PAINTSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41240-8653
Practice Address - Country:US
Practice Address - Phone:859-536-5578
Practice Address - Fax:606-395-5480
Is Sole Proprietor?:No
Enumeration Date:2011-04-30
Last Update Date:2011-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY014750183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist