Dillon Jerome Boe, RPH
Individual provider Active NPI Pharmacist · Fargo, ND
NPI 1508430992 · NPPES record last updated May 19, 2021
Key facts
- NPI
- 1508430992
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RPH6277 (ND)
- Practice address
- 2425 13TH Ave S
Fargo, ND 58103-3749 - Phone
- (701) 232-4872
- NPI assigned
- May 19, 2021
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH6277 | ND | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| American Drug Stores Delaware LLC | Past |
Accepting new patients | |
| West Acres Pharmacy Inc | Past | Accepting new patients | |
| American Drug Stores Delaware LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH6277 | ND | Yes |
Addresses
Primary practice location
2425 13TH Ave S
Fargo, ND 58103-3749
Mailing address
2425 13TH Ave S
Fargo, ND 58103-3749
Phone (701) 232-4872
Other providers in Fargo, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 19, 2021. 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.