Provider Demographics
NPI:1174821409
Name:FLOYD, DOUGLAS RAY (RPH)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:RAY
Last Name:FLOYD
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 GAPWAY ST
Mailing Address - Street 2:
Mailing Address - City:MULLINS
Mailing Address - State:SC
Mailing Address - Zip Code:29574-3414
Mailing Address - Country:US
Mailing Address - Phone:843-464-0118
Mailing Address - Fax:843-464-7375
Practice Address - Street 1:502 GAPWAY ST
Practice Address - Street 2:
Practice Address - City:MULLINS
Practice Address - State:SC
Practice Address - Zip Code:29574-3414
Practice Address - Country:US
Practice Address - Phone:843-464-0118
Practice Address - Fax:843-464-7375
Is Sole Proprietor?:No
Enumeration Date:2011-03-10
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9443183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist