Donan Boggess, PHARM.D
Individual provider Active NPI Pharmacist · Clinton, MS
NPI 1124397237 · NPPES record last updated Dec 19, 2011
Key facts
- NPI
- 1124397237
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- E-11778 (MS)
- Practice address
- 204 Highway 80 E
Clinton, MS 39056-4716 - Phone
- (601) 926-1179
- NPI assigned
- Dec 19, 2011
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E-11778 | MS | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past |
Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | E-11778 | MS | Yes |
Addresses
Primary practice location
204 Highway 80 E
Clinton, MS 39056-4716
Mailing address
204 Highway 80 E
Clinton, MS 39056-4716
Other providers in Clinton, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 19, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.