=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457561813
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | YVETTE GUARR AUSTIN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/23/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2451 FILLINGIM ST PHARMACY DEPARTMENT
-----------------------------------------------------
City | MOBILE
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 36617-2238
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 251-471-7388
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6411 VILLAGE POINT DR
-----------------------------------------------------
City | DAPHNE
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 36526-4726
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 251-626-6831
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 10912
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------