Angelo J. Boss, PHARMD
Individual provider Active NPI Pharmacist · Beale Afb, CA
NPI 1962040956 · NPPES record last updated Jun 16, 2026
Key facts
- NPI
- 1962040956
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 28392 (NC)
- Practice address
- 15301 Warren Shingle Rd
Beale Afb, CA 95903-1905 - Phone
- (530) 634-4818
- NPI assigned
- Dec 20, 2019
- Sex
- Male
- 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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28392 | NC | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28392 | NC | Yes |
Addresses
Primary practice location
15301 Warren Shingle Rd
Beale Afb, CA 95903-1905
Mailing address
15301 Warren Shingle Rd
Beale Afb, CA 95903-1905
Phone (530) 634-4818
Other providers in Beale Afb, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 16, 2026. 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.