Healthcare Provider Details

I. General information

NPI: 1194646216
Provider Name (Legal Business Name): ANNALISA YOUNGER PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 N LEHMBERG RD
COLUMBUS MS
39702-5541
US

IV. Provider business mailing address

4445 HIGHWAY 96
MILLPORT AL
35576-2235
US

V. Phone/Fax

Practice location:
  • Phone: 662-329-1810
  • Fax:
Mailing address:
  • Phone: 205-712-6848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number24666
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberE-102477
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: