Provider Demographics
NPI:1710215942
Name:LLOYD, EDNA (CRPH)
Entity Type:Individual
Prefix:MRS
First Name:EDNA
Middle Name:
Last Name:LLOYD
Suffix:
Gender:F
Credentials:CRPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2917 SE COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32025-3800
Mailing Address - Country:US
Mailing Address - Phone:386-365-2353
Mailing Address - Fax:386-752-8058
Practice Address - Street 1:2917 SE COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32025-3800
Practice Address - Country:US
Practice Address - Phone:386-365-2353
Practice Address - Fax:386-752-8058
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-30
Last Update Date:2009-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPU6587183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist