Provider Demographics
NPI:1073144721
Name:LOYD, ANDREA MARIE (RPH)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:MARIE
Last Name:LOYD
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 1:3767 LAMB DR
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-5921
Mailing Address - Country:US
Mailing Address - Phone:770-500-0770
Mailing Address - Fax:
Practice Address - Street 1:3600 DALLAS HWY SW
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-1675
Practice Address - Country:US
Practice Address - Phone:770-425-0552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-31
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH022785183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist