Provider Demographics
NPI:1003353921
Name:FLOYD, BETH JORDAN (RPH)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:JORDAN
Last Name:FLOYD
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 COLUMBUS CORNERS DR
Mailing Address - Street 2:
Mailing Address - City:WHITEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28472-4905
Mailing Address - Country:US
Mailing Address - Phone:910-640-1893
Mailing Address - Fax:910-640-2958
Practice Address - Street 1:200 COLUMBUS CORNERS DR
Practice Address - Street 2:
Practice Address - City:WHITEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28472-4905
Practice Address - Country:US
Practice Address - Phone:910-640-1893
Practice Address - Fax:910-640-2958
Is Sole Proprietor?:No
Enumeration Date:2017-01-30
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10959183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist