Provider Demographics
NPI:1982826491
Name:FLOYD, JOAN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:
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 1:949 ROBERT WHITFIELD RD
Mailing Address - Street 2:
Mailing Address - City:HURDLE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:27541-9176
Mailing Address - Country:US
Mailing Address - Phone:336-364-1582
Mailing Address - Fax:336-562-3223
Practice Address - Street 1:140 MAIN STREET
Practice Address - Street 2:
Practice Address - City:PROSPECT HILL
Practice Address - State:NC
Practice Address - Zip Code:27314
Practice Address - Country:US
Practice Address - Phone:336-562-5972
Practice Address - Fax:336-562-3223
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10909183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0202010498OtherVABOP
NC10909OtherNCBOP