Provider Demographics
NPI:1992851760
Name:BOYLE, BRENDA R (PHARM D)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:R
Last Name:BOYLE
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 1:1106 E WASHINGTON ST # 1106
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83712-7325
Mailing Address - Country:US
Mailing Address - Phone:208-921-9826
Mailing Address - Fax:
Practice Address - Street 1:1106 E WASHINGTON ST # 1106
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83712-7325
Practice Address - Country:US
Practice Address - Phone:208-921-9826
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP5951183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist