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NPI Code Detail

MEDICARE: CHERYL S BOONE RPH

MEDICARE: CHERYL S BOONE RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist15205NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
115205OTHERNCLICENSE

General Provider Information

NPI Number : 1366778821
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHERYL S BOONE RPH
Provider Business Mailing Address
First Line : 6181 7 LKS W
Second Line :
City : WEST END
State : NC
Zip : 27376-9320
Country : US
Telephone Number : 910-673-3217
Fax Number :
Provider Business Practice Location Address
First Line : 1706 N SANDHILLS BLVD
Second Line :
City : ABERDEEN
State : NC
Zip : 28315-2338
Country : US
Telephone Number : 910-944-1502
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2009
Last Update Date : 10/19/2009

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