MEDICARE: DR. ALEX PAUL YAWNY II PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	30702	NC
2	183500000X	Pharmacist	RP456090	PA
3	183500000X	Pharmacist	43143	SC

General Provider Information

NPI Number	:	1871266460
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEX PAUL YAWNY II PHARMD

Provider Business Mailing Address
First Line	:	568 BILLINGSLEY RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28211-1010
Country	:	US
Telephone Number	:	704-972-2119
Fax Number	:	980-272-4181

Provider Business Practice Location Address
First Line	:	4425 RANDOLPH RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28211-2325
Country	:	US
Telephone Number	:	704-972-2119
Fax Number	:	980-272-4181

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2021
Last Update Date	:	01/26/2026

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