Provider Demographics
NPI:1710407333
Name:YARBOROUGH, ALEXANDRIA VICTORIA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDRIA
Middle Name:VICTORIA
Last Name:YARBOROUGH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 WOODRUFF ROAD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607
Mailing Address - Country:US
Mailing Address - Phone:864-987-1090
Mailing Address - Fax:864-987-5013
Practice Address - Street 1:1211 WOODRUFF ROAD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607
Practice Address - Country:US
Practice Address - Phone:864-987-1090
Practice Address - Fax:864-987-5013
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-24
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC37217183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist