Makena Boehm
Individual provider Active NPI Pharmacist · Senatobia, MS
NPI 1508467341 · NPPES record last updated Nov 6, 2020
Key facts
- NPI
- 1508467341
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- E010547 (MS)
- Practice address
- 5219 Highway 51 N
Senatobia, MS 38668-1719 - Phone
- (662) 562-8266
- NPI assigned
- Nov 6, 2020
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E010547 | MS | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | E010547 | MS | Yes |
Addresses
Primary practice location
5219 Highway 51 N
Senatobia, MS 38668-1719
Mailing address
190 Love Rd
Hernando, MS 38632-0400
Other providers in Senatobia, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 6, 2020. 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.