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General NPI Number Information
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NPI Number | 1437201704
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Entity Type | Organization
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Legal Business Name | BOYD'S DRUG STORE,INC
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 101 W JEFFERSON ST BOX 662
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City | KOSCIUSKO
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State | MS
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Zip | 39090-3618
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Country | US
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Telephone | 662-289-2211
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Fax | 662-289-6973
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Provider Business Mailing Address
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Address Line | 101 W JEFFERSON ST BOX 662
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City | KOSCIUSKO
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State | MS
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Zip | 39090-3618
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Country | US
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Telephone | 662-289-2211
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Fax | 662-289-6973
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JAMES AMZIE BOYD JR.
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Credential | BS PHARMACY
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Telephone | 662-289-2211
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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 | E3663
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License Number State | MS
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