Provider Demographics
NPI:1679031769
Name:YOUNG, EVAN (PHARMD, BC-ADM)
Entity type:Individual
Prefix:DR
First Name:EVAN
Middle Name:
Last Name:YOUNG
Suffix:
Gender:M
Credentials:PHARMD, BC-ADM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 MILLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SHEPHERDSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40165-8901
Mailing Address - Country:US
Mailing Address - Phone:502-492-0049
Mailing Address - Fax:
Practice Address - Street 1:692 E BROADWAY ST
Practice Address - Street 2:
Practice Address - City:MONON
Practice Address - State:IN
Practice Address - Zip Code:47959-8191
Practice Address - Country:US
Practice Address - Phone:877-797-2404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-07
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26028742A1835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care