MEDICARE: SOYOUNG ALEXANDER

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	RPH031564	GA

General Provider Information

NPI Number	:	1669027058
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOYOUNG ALEXANDER

Provider Business Mailing Address
First Line	:	7525 HIGHLAND BLF
Second Line	:
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30328-2878
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4279 ROSWELL RD NE STE 300
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30342-3769
Country	:	US
Telephone Number	:	404-843-4353
Fax Number	:

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

Provider Enumeration Date	:	08/03/2019
Last Update Date	:	08/03/2019

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Directions to “ SOYOUNG ALEXANDER ” Practice Location

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