Provider Demographics
NPI:1437621943
Name:LLOYD'S WATER PAL CORPORATION
Entity Type:Organization
Organization Name:LLOYD'S WATER PAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BILLY
Authorized Official - Middle Name:L
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:I
Authorized Official - Credentials:
Authorized Official - Phone:575-202-6110
Mailing Address - Street 1:702 W 1ST ST
Mailing Address - Street 2:
Mailing Address - City:DEMING
Mailing Address - State:NM
Mailing Address - Zip Code:88030-3012
Mailing Address - Country:US
Mailing Address - Phone:575-202-6110
Mailing Address - Fax:
Practice Address - Street 1:622 WEST FIRST STREET
Practice Address - Street 2:SOON OTHER AT OTHER : 8700 EAST FOURTH STREET
Practice Address - City:DEMING
Practice Address - State:NM
Practice Address - Zip Code:88030
Practice Address - Country:US
Practice Address - Phone:575-202-6110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-21
Last Update Date:2018-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835N1003XPharmacy Service ProvidersPharmacistNutrition SupportGroup - Multi-Specialty