Provider Demographics
NPI:1346475456
Name:YATES, JOEL DUANE II (RPH, BS)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:DUANE
Last Name:YATES
Suffix:II
Gender:M
Credentials:RPH, BS
Other - Prefix:
Other - First Name:JODY
Other - Middle Name:
Other - Last Name:YATES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1216 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-2453
Mailing Address - Country:US
Mailing Address - Phone:803-358-3030
Mailing Address - Fax:803-358-3034
Practice Address - Street 1:1216 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-2453
Practice Address - Country:US
Practice Address - Phone:803-358-3030
Practice Address - Fax:803-358-3034
Is Sole Proprietor?:No
Enumeration Date:2009-05-18
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8732183500000X
GA18676183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist