Provider Demographics
NPI:1184914376
Name:YOUNG, RAYMOND LEE (PHARM D)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:LEE
Last Name:YOUNG
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1245 MALLARD CIR
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35405-6738
Mailing Address - Country:US
Mailing Address - Phone:662-801-5566
Mailing Address - Fax:
Practice Address - Street 1:4200 MCFARLAND BLVD E
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35405-3853
Practice Address - Country:US
Practice Address - Phone:205-759-1103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-09
Last Update Date:2011-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL15926183500000X
MSE-010341183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist