Mary Boules
Individual provider Active NPI Pharmacist · Rockingham, VA
NPI 1679959241 · NPPES record last updated Aug 6, 2015
Key facts
- NPI
- 1679959241
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 0202211457 (VA)
- Practice address
- 2041 Solera CT
Apt 202
Rockingham, VA 22801-2785 - Phone
- (703) 332-5795
- NPI assigned
- Aug 6, 2015
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0202211457 | VA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202211457 | VA | Yes |
Addresses
Primary practice location
2041 Solera CT
Apt 202
Rockingham, VA 22801-2785
Mailing address
2041 Solera CT
Apt 202
Rockingham, VA 22801-2785
Phone (703) 332-5795
Other providers in Rockingham, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 6, 2015. 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.