Provider Demographics
NPI:1598448672
Name:BROYLES, LENA KAY (PHARMD)
Entity Type:Individual
Prefix:
First Name:LENA
Middle Name:KAY
Last Name:BROYLES
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 1:31 BEASLEY BEND RD
Mailing Address - Street 2:
Mailing Address - City:RIDDLETON
Mailing Address - State:TN
Mailing Address - Zip Code:37151-2106
Mailing Address - Country:US
Mailing Address - Phone:161-548-9751
Mailing Address - Fax:
Practice Address - Street 1:1104 CULLMAN SHOPPING CTR NW
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-2855
Practice Address - Country:US
Practice Address - Phone:256-736-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL23185183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist