Provider Demographics
NPI:1821376831
Name:BOYETT, MEGAN (PHARM D)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:BOYETT
Suffix:
Gender:F
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:PO BOX 505
Mailing Address - Street 2:
Mailing Address - City:SULLIGENT
Mailing Address - State:AL
Mailing Address - Zip Code:35586-0505
Mailing Address - Country:US
Mailing Address - Phone:205-698-9770
Mailing Address - Fax:205-698-8522
Practice Address - Street 1:55298 HWY 17
Practice Address - Street 2:
Practice Address - City:SULLIGENT
Practice Address - State:AL
Practice Address - Zip Code:35586
Practice Address - Country:US
Practice Address - Phone:205-698-9770
Practice Address - Fax:205-698-8522
Is Sole Proprietor?:No
Enumeration Date:2011-07-25
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL16179183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist