Mary Tokunboh, PHARMD
Individual provider Active NPI Pharmacist · Boyce, LA
NPI 1992345250 · NPPES record last updated Jan 14, 2020
Key facts
- NPI
- 1992345250
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 23287 (LA)
- Practice address
- 513 Ulster Ave
Boyce, LA 71409 - Phone
- (318) 793-2400
- NPI assigned
- Jan 14, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
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 |
|---|---|---|---|
| 23287 | LA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boyce Family Clinic and Urgent Care LLC | Current |
Accepting new patients | |
| Boyce Pharmacy | Past |
Accepting new patients |
Locations
513 Ulster Ave
Boyce, LA 71409
Phone (318) 793-2400
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 23287 | LA | Yes |
Addresses
Primary practice location
513 Ulster Ave
Boyce, LA 71409
Mailing address
513 Ulster Ave
Boyce, LA 71409
Phone (318) 793-2400
Other providers in Boyce, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 14, 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.