Provider Demographics
NPI:1902986342
Name:BOYD PHARMACIST GROUP, LLC
Entity Type:Organization
Organization Name:BOYD PHARMACIST GROUP, LLC
Other - Org Name:BOYD COUNTY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER / TECH
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:FERGUSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-929-5301
Mailing Address - Street 1:12544 US ROUTE 60
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41102
Mailing Address - Country:US
Mailing Address - Phone:606-929-5301
Mailing Address - Fax:
Practice Address - Street 1:12544 US ROUTE 60
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41102
Practice Address - Country:US
Practice Address - Phone:606-929-5301
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYP07129332BX2000X
333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1829677OtherNABP