1306920566 NPI number — MARILYN JEAN YURCHICK RPH

Table of content: MARILYN JEAN YURCHICK RPH (NPI 1306920566)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306920566 NPI number — MARILYN JEAN YURCHICK RPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
YURCHICK
Provider First Name:
MARILYN
Provider Middle Name:
JEAN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RPH
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306920566
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13 VANBUREN STREET
Provider Second Line Business Mailing Address:
PO BOX 242
Provider Business Mailing Address City Name:
COKEBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15324
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
101 INDEPENDENCE STREET
Provider Second Line Business Practice Location Address:
BOX 314
Provider Business Practice Location Address City Name:
PERRYOPOLIS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15473
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-736-4422
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  RP028239L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: RP028239L . This is a "PHARMACY LICENSE NUMBER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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