Boulevard Pharmacy Inc
Boulevard Pharmacy Inc is a healthcare organization registered as Community/Retail Pharmacy in Eden, NC, holding Type 2 (organization) NPI 1104924133 since 2006. The authorized official on file is William Johnson, Owner Manager President.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1104924133 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Boulevard Pharmacy Inc |
| Practice address | 256 THE BLVD, Eden, NC, 27288 |
| Phone | 3366238448 |
| Fax | 3366231934 |
| Enumeration date | 2006-09-21 |
| Last updated in NPPES | 2025-09-11 |
Authorized official
| Name | William Johnson |
|---|---|
| Title | Owner Manager President |
| Phone | 3366238881 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 333600000X | Pharmacy | Secondary | 06995 | NC |
| 3336C0003X | Community/Retail Pharmacy | Primary | — | — |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3430674 | Other | — | OTHER ID NUMBER-COMMERCIAL NUMBER |
| 0795732 | Medicaid | NC | — |
Copy-ready billing details
Provider: Boulevard Pharmacy Inc NPI: 1104924133 Taxonomy: 3336C0003X (Community/Retail Pharmacy) Address: 256 THE BLVD, Eden, NC, 27288
Verify this record
Cross-check NPI 1104924133 against the authoritative CMS record: view Boulevard Pharmacy Inc on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What type of organization is Boulevard Pharmacy Inc?
What is a Type 2 NPI?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2025-09-11.