Healthcare Provider Details

I. General information

NPI: 1972278695
Provider Name (Legal Business Name): RACHAEL BOYD PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2021
Last Update Date: 08/13/2021
Certification Date: 08/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 CENTRAL AVE SE
ALBUQUERQUE NM
87106-4934
US

IV. Provider business mailing address

1100 CENTRAL AVE SE
ALBUQUERQUE NM
87106-4934
US

V. Phone/Fax

Practice location:
  • Phone: 505-841-1545
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP00007662
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: