Provider Demographics
NPI:1558978536
Name:LLOYD, ERIC (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:LLOYD
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1247
Mailing Address - Street 2:
Mailing Address - City:MOUNT GAY
Mailing Address - State:WV
Mailing Address - Zip Code:25637-1247
Mailing Address - Country:US
Mailing Address - Phone:304-752-1445
Mailing Address - Fax:304-752-1468
Practice Address - Street 1:360 MOUNT GAY ROAD
Practice Address - Street 2:
Practice Address - City:MOUNT GAY
Practice Address - State:WV
Practice Address - Zip Code:25637
Practice Address - Country:US
Practice Address - Phone:304-752-1445
Practice Address - Fax:304-752-1468
Is Sole Proprietor?:No
Enumeration Date:2020-09-24
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0005837183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist