Provider Demographics
NPI:1801619762
Name:BOYDS PHARMACY OF MEDFORD INC
Entity type:Organization
Organization Name:BOYDS PHARMACY OF MEDFORD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:TOOTELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-894-1679
Mailing Address - Street 1:5 WILKINS STATION RD STE 100
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-9606
Mailing Address - Country:US
Mailing Address - Phone:609-975-8197
Mailing Address - Fax:609-975-8223
Practice Address - Street 1:5 WILKINS STATION RD STE 100
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-9606
Practice Address - Country:US
Practice Address - Phone:609-975-8197
Practice Address - Fax:609-975-8223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy