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MR. LARRY KEITH BOYETT R.PH.

>> Pharmacist >> Pharmacy Service Providers

Registrant NPI Number: 1255494415

Individual Registrant:
MR. LARRY KEITH BOYETT R.PH.
Gender: M
Not Sole Proprietor

Location and contact information for practice:
MT. VERNON PHARMACY 19390 HWY 43 & MILDRED ST. MT. VERNON, AL 36560 US
Tel: 251-829-6628  Fax: --

Contact information for business:
11336 OLD HIGHWAY 43  AXIS, AL 36505-4600 US
Tel: 251-675-5185  Fax: --

Registration Information:
NPI: 1255494415
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y183500000XPharmacy Service Providers
Pharmacist
AL10148

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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