MEDICARE: SALFITI BOYD PHARMACY, LLC

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
1	3336C0004X	Compounding Pharmacy	28261	TX
2	3336C0003X	Community/Retail Pharmacy	28261	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811249865
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SALFITI BOYD PHARMACY, LLC

Provider Business Mailing Address
First Line	:	417 W ROCK ISLAND AVE
Second Line	:
City	:	BOYD
State	:	TX
Zip	:	76023-3103
Country	:	US
Telephone Number	:	940-433-8056
Fax Number	:	940-433-8059

Provider Business Practice Location Address
First Line	:	417 W ROCK ISLAND AVE
Second Line	:
City	:	BOYD
State	:	TX
Zip	:	76023-3103
Country	:	US
Telephone Number	:	940-433-8056
Fax Number	:

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	RAJA SALFITI
Credential	:
Telephone Number	:	817-532-6112

Provider Enumeration Date	:	10/15/2012
Last Update Date	:	04/11/2025

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