Provider Demographics
NPI:1841306263
Name:LLOYD, CHARLES KENNETH (RPH)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:KENNETH
Last Name:LLOYD
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:PO BOX 441
Mailing Address - Street 2:
Mailing Address - City:BERRY
Mailing Address - State:AL
Mailing Address - Zip Code:35546-0441
Mailing Address - Country:US
Mailing Address - Phone:205-689-4777
Mailing Address - Fax:205-689-4778
Practice Address - Street 1:31 DEPOT ST
Practice Address - Street 2:
Practice Address - City:BERRY
Practice Address - State:AL
Practice Address - Zip Code:35546-0441
Practice Address - Country:US
Practice Address - Phone:205-689-4777
Practice Address - Fax:205-689-4778
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9224183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL9224OtherPHARMACY LICENSE NUMBER