Provider Demographics
NPI:1649399676
Name:YACONETTI, ALBERT (RPH)
Entity Type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:
Last Name:YACONETTI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7832 SETON HOUSE LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-5564
Mailing Address - Country:US
Mailing Address - Phone:704-246-4711
Mailing Address - Fax:
Practice Address - Street 1:7832 SETON HOUSE LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-5564
Practice Address - Country:US
Practice Address - Phone:704-246-4711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18204183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist