Healthcare Provider Details

I. General information

NPI: 1821085853
Provider Name (Legal Business Name): AMANDA WHITEHEAD BOYD PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 03/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1513 LIVE OAK ST
BEAUFORT NC
28516-1518
US

IV. Provider business mailing address

402 ISLAND DR
BEAUFORT NC
28516-9408
US

V. Phone/Fax

Practice location:
  • Phone: 252-504-2800
  • Fax:
Mailing address:
  • Phone: 252-339-3427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number17726
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: