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General NPI Number Information
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NPI Number | 1104488428
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Entity Type | Individual
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Provider Name | CHANEY M BOYLE PHARMD
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Gender | Male
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Dates
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Enumeration Date | 07/08/2019
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Last Update Date | 07/08/2019
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Provider Practice Location Address
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Address Line | 802 E MEDICAL CT
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City | POST FALLS
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State | ID
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Zip | 83854-7298
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Country | US
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Telephone | 208-773-3566
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Fax |
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Provider Business Mailing Address
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Address Line | 802 E MEDICAL CT
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City | POST FALLS
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State | ID
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Zip | 83854-7298
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Country | US
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Telephone |
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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 | P8380
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License Number State | ID
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