Healthcare Provider Details

I. General information

NPI: 1255972758
Provider Name (Legal Business Name): CYNTHIA KAY BOYD RPH, PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2019
Last Update Date: 10/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 1ST ST
KENNETT MO
63857-2522
US

IV. Provider business mailing address

6135 BOSKEY DR
MILLINGTON TN
38053-6901
US

V. Phone/Fax

Practice location:
  • Phone: 573-888-4543
  • Fax:
Mailing address:
  • Phone: 573-268-1152
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number42628
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPD14780
License Number StateAR
# 3
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2005040943
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: