Provider Demographics
NPI:1275574337
Name:FLOYD, STEPHEN W (RPH)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:W
Last Name:FLOYD
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 HOLMAN DR
Mailing Address - Street 2:POB 245
Mailing Address - City:HEADLAND
Mailing Address - State:AL
Mailing Address - Zip Code:36345-2307
Mailing Address - Country:US
Mailing Address - Phone:334-693-3324
Mailing Address - Fax:334-693-5051
Practice Address - Street 1:202 HOLMAN DR
Practice Address - Street 2:POB 245
Practice Address - City:HEADLAND
Practice Address - State:AL
Practice Address - Zip Code:36345-2307
Practice Address - Country:US
Practice Address - Phone:334-693-3324
Practice Address - Fax:334-693-5051
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL7839183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL15080OtherFLORIDA PHARMACY LICENSE
AL7839OtherALABAMA PHARMACY LICENSE