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General NPI Number Information
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NPI Number | 1033492699
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Entity Type | Individual
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Provider Name | MERCEDES DEMETRIA BOYKIN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 09/21/2011
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Last Update Date | 09/21/2011
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Provider Practice Location Address
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Address Line | 3800 PRINCETON LAKES PKWY SW
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City | ATLANTA
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State | GA
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Zip | 30331-5580
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Country | US
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Telephone | 404-344-5158
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Fax | 404-344-5828
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Provider Business Mailing Address
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Address Line | 45 SHERIDAN DR NE APT 18
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City | ATLANTA
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State | GA
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Zip | 30305-3132
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Country | US
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Telephone | 314-570-2170
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 15433
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 025338
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2007036317
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License Number State | MO
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