Provider Demographics
NPI:1649676776
Name:STICE, FLOYD LELAN (RPH)
Entity type:Individual
Prefix:DR
First Name:FLOYD
Middle Name:LELAN
Last Name:STICE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 ELMWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71603-7140
Mailing Address - Country:US
Mailing Address - Phone:501-442-4657
Mailing Address - Fax:
Practice Address - Street 1:22 ELMWOOD CIR
Practice Address - Street 2:
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71603-7140
Practice Address - Country:US
Practice Address - Phone:501-442-4657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-17
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD09215183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist