=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871266460
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALEX PAUL YAWNY II PHARMD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/29/2021
-----------------------------------------------------
Last Update Date | 01/26/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4425 RANDOLPH RD
-----------------------------------------------------
City | CHARLOTTE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28211-2325
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-972-2119
-----------------------------------------------------
Fax | 980-272-4181
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 568 BILLINGSLEY RD
-----------------------------------------------------
City | CHARLOTTE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28211-1010
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-972-2119
-----------------------------------------------------
Fax | 980-272-4181
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 30702
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | RP456090
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 43143
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------