Provider Demographics
NPI:1124311774
Name:BOYER, FADIA (RPH)
Entity type:Individual
Prefix:
First Name:FADIA
Middle Name:
Last Name:BOYER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 NEW DEER LN
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-9771
Mailing Address - Country:US
Mailing Address - Phone:919-803-7834
Mailing Address - Fax:
Practice Address - Street 1:270 GRANDE HEIGHTS DR
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-3925
Practice Address - Country:US
Practice Address - Phone:919-380-1607
Practice Address - Fax:919-469-4702
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-16
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21451183500000X
WV5107183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist