IndividualActive
Antwon Boston, PHARMD
NPI 1295321669 · Military Health Care Provider · Fort Polk, LA
Provider details
- NPI number
- 1295321669
- Entity type
- Individual
- Primary specialty
- Military Health Care ProviderOther Service Providers
- Credential
- PHARMD
- Sex
- Male
- Sole proprietor
- No
- License
- PHCY-04573 (NH)
Specialties & taxonomies
Other Service Providers
Practice location
1585 3rd St Bldg 285
Fort Polk, LA 71459-5102
Phone: (337) 531-8090
Approximate (ZIP-level) locationGet directions
Mailing address
5965 Harrell St Apt B
Fort Polk, LA 71459-3698
Registry dates
- Enumerated
- 2020-12-18
- Last updated
- 2020-12-18
- Certified
- 2020-12-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.