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Individual

JAMES L YOUNGBLOOD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
2711 CORNER CT, ALTON, IL 62002-5328
(618) 462-0052
(618) 462-8114
Mailing address
2711 CORNER CT, ALTON, IL 62002-5328
(618) 462-0052
(618) 462-8114

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
545740
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
371000048001
IL
Enumeration date
01/19/2007
Last updated
07/08/2007
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