Healthcare Provider Details

I. General information

NPI: 1215045745
Provider Name (Legal Business Name): ANDREA L BOYD PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W. CLAY AVE PLATTSBURG CLINIC PHARMACY
PLATTSBURG MO
64477
US

IV. Provider business mailing address

5604 MEADOW CT S
PARKVILLE MO
64152-6116
US

V. Phone/Fax

Practice location:
  • Phone: 816-539-2121
  • Fax: 816-539-3823
Mailing address:
  • Phone: 816-539-2121
  • Fax: 816-539-3823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2000169287
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: