Provider Demographics
NPI:1790843191
Name:BOYKO, WILLIAM LOUIS JR (PHARMD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:LOUIS
Last Name:BOYKO
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 WILMINGTON PIKE
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-4819
Mailing Address - Country:US
Mailing Address - Phone:937-293-1919
Mailing Address - Fax:937-293-0994
Practice Address - Street 1:3600 WILMINGTON PIKE
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-4819
Practice Address - Country:US
Practice Address - Phone:937-293-1919
Practice Address - Fax:937-293-0994
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03219419183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist