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NPI Code Detail

MEDICARE: MRS. KRISTIE SUMMER BOYKIN

MEDICARE: MRS. KRISTIE SUMMER BOYKIN
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
1183500000XPharmacist14869AL

General Provider Information

NPI Number : 1821340761
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KRISTIE SUMMER BOYKIN
Provider Business Mailing Address
First Line : 3325 UNIVERSITY BLVD E
Second Line :
City : TUSCALOOSA
State : AL
Zip : 35404-4339
Country : US
Telephone Number : 205-556-3800
Fax Number : 205-556-0142
Provider Business Practice Location Address
First Line : 3325 UNIVERSITY BLVD E
Second Line :
City : TUSCALOOSA
State : AL
Zip : 35404-4339
Country : US
Telephone Number : 205-556-3800
Fax Number : 205-556-0142
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2012
Last Update Date : 10/28/2012

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