Provider Demographics
NPI:1902172091
Name:BOYLE, GLENDA MILEY (RPH)
Entity Type:Individual
Prefix:
First Name:GLENDA
Middle Name:MILEY
Last Name:BOYLE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3050 ASHLEY TOWN CENTER DR
Mailing Address - Street 2:COSTCO PHARMACY
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-5664
Mailing Address - Country:US
Mailing Address - Phone:843-460-2002
Mailing Address - Fax:843-460-2020
Practice Address - Street 1:1215 GILMORE RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-5332
Practice Address - Country:US
Practice Address - Phone:843-763-0681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-22
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8523183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist