Provider Demographics
NPI:1891458774
Name:BOYD, PAMELA PAIGE (RPH)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:PAIGE
Last Name:BOYD
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 1:671 WYNDHAM WAY
Mailing Address - Street 2:
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322-3624
Mailing Address - Country:US
Mailing Address - Phone:912-592-2445
Mailing Address - Fax:
Practice Address - Street 1:671 WYNDHAM WAY
Practice Address - Street 2:
Practice Address - City:POOLER
Practice Address - State:GA
Practice Address - Zip Code:31322-3624
Practice Address - Country:US
Practice Address - Phone:912-592-2445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-18
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA025088183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist