Provider Demographics
NPI:1841569407
Name:BOLDUC, JOCELYN (RPH)
Entity Type:Individual
Prefix:
First Name:JOCELYN
Middle Name:
Last Name:BOLDUC
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1002 DIXIELAND RD
Mailing Address - Street 2:TARGET PHARMACY T-0802
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78552-5913
Mailing Address - Country:US
Mailing Address - Phone:956-440-8329
Mailing Address - Fax:956-440-8329
Practice Address - Street 1:1002 DIXIELAND RD
Practice Address - Street 2:TARGET PHARMACY T-0802
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78552-5913
Practice Address - Country:US
Practice Address - Phone:956-440-8329
Practice Address - Fax:956-440-8329
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-27
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50937183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist