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General NPI Number Information
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NPI Number | 1801619762
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Entity Type | Organization
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Legal Business Name | BOYDS PHARMACY OF MEDFORD INC
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Dates
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Enumeration Date | 11/07/2024
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Last Update Date | 11/07/2024
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Provider Practice Location Address
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Address Line | 5 WILKINS STATION RD STE 100
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City | MEDFORD
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State | NJ
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Zip | 08055-9606
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Country | US
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Telephone | 609-975-8197
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Fax | 609-975-8223
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Provider Business Mailing Address
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Address Line | 5 WILKINS STATION RD STE 100
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City | MEDFORD
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State | NJ
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Zip | 08055-9606
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Country | US
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Telephone | 609-975-8197
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Fax | 609-975-8223
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Authorized Official
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Title or Position | PRESIDENT
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Name | MATTHEW TOOTELL
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Credential |
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Telephone | 609-894-1679
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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