Provider Demographics
NPI:1912291105
Name:BOYER, ROBERT CLINTON (RPH)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:CLINTON
Last Name:BOYER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9785 JEFFERSON DAVIS HWY
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-9406
Mailing Address - Country:US
Mailing Address - Phone:540-834-1441
Mailing Address - Fax:540-834-1451
Practice Address - Street 1:9785 JEFFERSON DAVIS HWY
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-9406
Practice Address - Country:US
Practice Address - Phone:540-834-1441
Practice Address - Fax:540-834-1451
Is Sole Proprietor?:No
Enumeration Date:2011-06-05
Last Update Date:2011-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202010619183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist