Provider Demographics
NPI:1770913998
Name:BOICE, ALEASHA RAE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ALEASHA
Middle Name:RAE
Last Name:BOICE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:MOUND CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66056-5241
Mailing Address - Country:US
Mailing Address - Phone:785-304-5392
Mailing Address - Fax:
Practice Address - Street 1:625 MAIN ST
Practice Address - Street 2:
Practice Address - City:MOUND CITY
Practice Address - State:KS
Practice Address - Zip Code:66056-9100
Practice Address - Country:US
Practice Address - Phone:913-795-4435
Practice Address - Fax:913-795-4437
Is Sole Proprietor?:No
Enumeration Date:2013-11-25
Last Update Date:2014-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD11537183500000X
KS1-14757183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist