Provider Demographics
NPI:1912008228
Name:BOYCE, ROBERT W (RPH)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:W
Last Name:BOYCE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:109 PLAGEMAN BLDG
Mailing Address - Street 2:OSU PHARMACY
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97331
Mailing Address - Country:US
Mailing Address - Phone:541-737-3491
Mailing Address - Fax:541-737-7616
Practice Address - Street 1:109 PLAGEMAN BLDG
Practice Address - Street 2:OSU PHARMACY
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97331
Practice Address - Country:US
Practice Address - Phone:541-737-3491
Practice Address - Fax:541-737-7616
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0006445183500000X
ORRPH00064451835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORRPH-0006445OtherPHARMACIST LICENSE