Provider Demographics
NPI:1902016074
Name:FLOYD, AMY L (RPH)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:L
Last Name:FLOYD
Suffix:
Gender:F
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:RR 2 BOX 130F
Mailing Address - Street 2:HOWELLS MILL ROAD
Mailing Address - City:ONA
Mailing Address - State:WV
Mailing Address - Zip Code:25545-9625
Mailing Address - Country:US
Mailing Address - Phone:304-743-6175
Mailing Address - Fax:
Practice Address - Street 1:259 STATE ST
Practice Address - Street 2:FRUTH PHARMACY
Practice Address - City:PROCTORVILLE
Practice Address - State:OH
Practice Address - Zip Code:45669-4011
Practice Address - Country:US
Practice Address - Phone:740-886-7685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV03-3-24012183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist