Basic Information
| Provider Information | |||||||||
| NPI: | 1831567536 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BOYD | ||||||||
| FirstName: | JENNIE | ||||||||
| MiddleName: | KATHARINE | ||||||||
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| Credential: | PHARMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1173 INVERNESS COVE WAY | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352424258 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2052402468 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 800 LAKESHORE DR | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352290001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2057264367 | ||||||||
| FaxNumber: | 2057262669 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/11/2015 | ||||||||
| LastUpdateDate: | 09/11/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 16941 | AL | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.