1700165677 NPI number — DR. MEGAN RENEE CAMPBELL YOST PHARMD

Table of content: DR. MEGAN RENEE CAMPBELL YOST PHARMD (NPI 1700165677)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700165677 NPI number — DR. MEGAN RENEE CAMPBELL YOST PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CAMPBELL YOST
Provider First Name:
MEGAN
Provider Middle Name:
RENEE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
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:
1700165677
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/10/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2929 STUARTS DRAFT HIGHWAY SUITE 101
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STUARTS DRAFT
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24477
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-337-3776
Provider Business Mailing Address Fax Number:
540-337-9321

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2929 STUARTS DRAFT HIGHWAY
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
STUARTS DRAFT
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24477
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-337-3776
Provider Business Practice Location Address Fax Number:
540-337-9321
Provider Enumeration Date:
08/10/2011

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:  0202208070 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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