Young's Pharmacy & General Store, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

028426 Issued in NY

Legal business name

YOUNG'S PHARMACY & GENERAL STORE, LLC

Practice address

1636 Burden Lake Road
Averill Park, NY 12018-2808

Phone

(518) 674-3663

Fax

(518) 674-1400

NPI assigned

Jun 21, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Miller Young, PHARM.D.NPI 1497949085

Title

Supervising Pharmacist

Phone

(518) 674-3663

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY3 enrollments

Enrollment records 3

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare medical equipment & supply locations

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Miller Young, PHARM.D.

  • Pharmacist
  • Averill Park, NY
  • NPI 1497949085
  NPD Authorized official
• Evelynn Ginsburg, RPH

  • Pharmacist
  • Averill Park, NY
  • NPI 1750619888
  NPD (past)
• Stephanie J Young, PHARM.D.

  • Pharmacist
  • Averill Park, NY
  • NPI 1134292824
  NPD (past)

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200614400000",
    "number": "1447456116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1636 BURDEN LAKE ROAD",
            "city": "AVERILL PARK",
            "state": "NY",
            "postal_code": "120182808",
            "telephone_number": "518-674-3663",
            "fax_number": "518-674-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1636 BURDEN LAKE ROAD",
            "city": "AVERILL PARK",
            "state": "NY",
            "postal_code": "120182808",
            "telephone_number": "518-674-3663",
            "fax_number": "518-674-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUNG'S PHARMACY & GENERAL STORE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-21",
        "last_updated": "2008-01-18",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "MILLER",
        "authorized_official_title_or_position": "SUPERVISING PHARMACIST",
        "authorized_official_telephone_number": "518-674-3663",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "028426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LICENSE NUMBER",
            "identifier": "028426",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "3354761",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kory C Weaver, LCSW
• Brenda J Westbrook, M.S., CCC-SLP
• Bonnie Wisnewski, LMHC
• Miller Young, PHARM.D.
• Stephanie J Young, PHARM.D.

• Community/Retail Pharmacy in Averill Park, NY
• Providers in Averill Park, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.