Julie Lynn Boles, RPH
Individual provider Active NPI Pharmacist · Christopher, IL
NPI 1609995430 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1609995430
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 051040223 (IL)
- Practice address
- 4241 State Hwy 14 West
Rea Clinic Pharmacy
Christopher, IL 62822 - Phone
- (618) 724-2136
- Fax
- (618) 724-1669
- NPI assigned
- Mar 29, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| 051040223 | IL | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051040223 | IL | Yes |
Addresses
Primary practice location
4241 State Hwy 14 West
Rea Clinic Pharmacy
Christopher, IL 62822
Mailing address
PO Box 155
Rea Clinic
Christopher, IL 62822
Phone (618) 724-2401
Other providers in Christopher, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.