Healthcare Provider Details

I. General information

NPI: 1659693588
Provider Name (Legal Business Name): ANITA JOY YEAGER RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2010
Last Update Date: 08/03/2020
Certification Date: 08/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 HIGHWAY 231 S
TROY AL
36081-3067
US

IV. Provider business mailing address

1330 HIGHWAY 231 S
TROY AL
36081-3067
US

V. Phone/Fax

Practice location:
  • Phone: 334-670-5453
  • Fax: 334-670-5338
Mailing address:
  • Phone: 334-670-5453
  • Fax: 334-670-5338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH019786
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number15443
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: