MEDICARE: DR. RAYMOND LEE YOUNG PHARM D

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	15926	AL
2	183500000X	Pharmacist	E-010341	MS

General Provider Information

NPI Number	:	1184914376
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAYMOND LEE YOUNG PHARM D

Provider Business Mailing Address
First Line	:	1245 MALLARD CIR
Second Line	:
City	:	TUSCALOOSA
State	:	AL
Zip	:	35405-6738
Country	:	US
Telephone Number	:	662-801-5566
Fax Number	:

Provider Business Practice Location Address
First Line	:	4200 MCFARLAND BLVD E
Second Line	:
City	:	TUSCALOOSA
State	:	AL
Zip	:	35405-3853
Country	:	US
Telephone Number	:	205-759-1103
Fax Number	:

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

Provider Enumeration Date	:	04/09/2011
Last Update Date	:	04/09/2011

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