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NPI Code Detail

MEDICARE: MRS. VICKI MCCONKEY BOOZER RPH

MEDICARE: MRS. VICKI MCCONKEY BOOZER RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11835G0303XGeriatric Pharmacist4438SC

General Provider Information

NPI Number : 1326111097
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. VICKI MCCONKEY BOOZER RPH
Provider Business Mailing Address
First Line : 110 EDWARD CT
Second Line :
City : COLUMBIA
State : SC
Zip : 29205-2710
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1308 LAUREL ST
Second Line :
City : COLUMBIA
State : SC
Zip : 29201-2514
Country : US
Telephone Number : 803-931-8123
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2006
Last Update Date : 07/08/2007

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Directions to “ MRS. VICKI MCCONKEY BOOZER RPH” Practice Location

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