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YOUNG LIFE ENTERPRISE LLC NPI 1922537000


NPI Information

NPI: 1922537000
Provider Name: YOUNG LIFE ENTERPRISE LLC

Doing Business As: YOUNG LIFE PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

CLIA Number: 11D2168736

Address:
1769 CANDLER RD
DECATUR, GA
ZIP 30032
Phone: (678) 772-8623
Get Directions

YOUNG LIFE ENTERPRISE LLC is a community/retail pharmacy pharmacy in Decatur, GA. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. YOUNG LIFE ENTERPRISE LLC NPI is 1922537000. The provider is registered as an organization entity type.
The provider Is Doing Business As Young Life Pharmacy.

The provider's business location address is:

1769 CANDLER RD
DECATUR, GA
ZIP 30032-276
Phone: (678) 772-8623

The provider's authorized official is Samuel Young .
The authorized official title is Pharmacist and has the following contact phone number (678) 772-8623.

The CLIA number assigned to this NPI record is 11D2168736 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/12/2017 and was last updated on 3/25/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
13336C0003XPharmacyCommunity/Retail PharmacyYes
23336M0002XPharmacyMail Order PharmacyNo
33336S0011XPharmacySpecialty PharmacyNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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