John Tyler Young, PHARMD
Individual provider Active NPI Pharmacist · Barnesville, GA
NPI 1750007373 · NPPES record last updated Oct 14, 2022
Key facts
- NPI
- 1750007373
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RPH030633 (GA)
- Practice address
- 302 College Dr
Barnesville, GA 30204-1602 - Phone
- (770) 358-2266
- Fax
- (770) 358-4497
- NPI assigned
- Oct 14, 2022
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH030633 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hines Prescription Shop, Inc. | Current |
Accepting new patients | |
| Roberta Pharmacy LLC | Current | Accepting new patients |
Locations
302 College Dr
Barnesville, GA 30204
Phone (770) 358-2266
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH030633 | GA | Yes |
Addresses
Primary practice location
302 College Dr
Barnesville, GA 30204-1602
Mailing address
302 College Dr
Barnesville, GA 30204-1602
Phone (770) 358-2266
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1 | Other | NOT APPLICABLE |
Other providers in Barnesville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 14, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.