Youngs Medicare Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

AR08078 Issued in AR

Legal business name

YOUNGS MEDICARE PHARMACY

Practice address

1304 S Main St
Malvern, AR 72104-5228

Phone

(501) 337-4901

Fax

(501) 337-7420

NPI assigned

Apr 18, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

John Young

Title

Owner

Phone

(501) 337-0277

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• young's healthmart pharmacy Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487548800000",
    "number": "1194941948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 S MAIN ST",
            "city": "MALVERN",
            "state": "AR",
            "postal_code": "721045228",
            "telephone_number": "501-337-4901",
            "fax_number": "501-337-7420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 S MAIN ST",
            "city": "MALVERN",
            "state": "AR",
            "postal_code": "721045228",
            "telephone_number": "501-337-4901",
            "fax_number": "501-337-7420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUNGS MEDICARE PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2017-02-20",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-337-0277"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AR",
            "license": "AR08078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1993612",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100617407",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "young's healthmart pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Xtend My Hair Salon & Co LLC
• Breanna Young
• Kadazjia Young
• Monica Young
• Whitni K Young, RECOVERY ASSISTANT
• Ryan Zotz, QBHP

• Community/Retail Pharmacy in Malvern, AR
• Providers in Malvern, AR by specialty
• Community/Retail Pharmacy in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.