Healthcare Provider Details

I. General information

NPI: 1851301659
Provider Name (Legal Business Name): BOYD'S PHARMACY OF PEMBERTON, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 10/02/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 FORT DIX RD
PEMBERTON NJ
08068-1439
US

IV. Provider business mailing address

17 FORT DIX RD
PEMBERTON NJ
08068-1439
US

V. Phone/Fax

Practice location:
  • Phone: 609-894-8288
  • Fax: 609-894-2225
Mailing address:
  • Phone: 609-894-8288
  • Fax: 609-894-2225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. THOMAS F GRECO
Title or Position: VICE PRESIDENT
Credential:
Phone: 609-894-8288