Provider Demographics
NPI:1497078679
Name:YOUNG, CHERI R (RPH)
Entity type:Individual
Prefix:MISS
First Name:CHERI
Middle Name:R
Last Name:YOUNG
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:851 HWY 6 E
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240
Mailing Address - Country:US
Mailing Address - Phone:319-351-1768
Mailing Address - Fax:847-396-2864
Practice Address - Street 1:851 HWY 6 E
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240
Practice Address - Country:US
Practice Address - Phone:319-351-1768
Practice Address - Fax:847-396-2864
Is Sole Proprietor?:No
Enumeration Date:2010-03-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA16223183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0153874Medicaid
IA0153874Medicaid
IA0153874Medicaid
IAP00151754Medicare PIN