Provider Demographics
NPI:1669125993
Name:BOYD, LARDNER CLARK IV (RPH, PHARMD, MBA)
Entity type:Individual
Prefix:DR
First Name:LARDNER
Middle Name:CLARK
Last Name:BOYD
Suffix:IV
Gender:M
Credentials:RPH, PHARMD, MBA
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 1
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:NJ
Mailing Address - Zip Code:08518-0001
Mailing Address - Country:US
Mailing Address - Phone:609-499-0100
Mailing Address - Fax:609-499-9628
Practice Address - Street 1:306 BROAD ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:NJ
Practice Address - Zip Code:08518-1912
Practice Address - Country:US
Practice Address - Phone:609-499-0100
Practice Address - Fax:609-499-9628
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-27
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RIO3850500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist