Individual
GEVONI BOLDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1619 DELAWARE AVE, MCCOMB, MS 39648-3609
(601) 684-8670
(601) 684-3465
Mailing address
2041 BETTY BLVD, MARRERO, LA 70072-4613
(504) 812-9259
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PST.019165
LA
Other
Enumeration date
02/05/2018
Last updated
02/05/2018
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