1992752307 NPI number — FLOYD PHARMACEUTICAL SERVICES INC

Table of content: (NPI 1992752307)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992752307 NPI number — FLOYD PHARMACEUTICAL SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FLOYD PHARMACEUTICAL SERVICES INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HEADLAND DISCOUNT PHARMACY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1992752307
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
202 HOLMAN DR
Provider Second Line Business Mailing Address:
POB 245
Provider Business Mailing Address City Name:
HEADLAND
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36345-2307
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
334-693-3324
Provider Business Mailing Address Fax Number:
334-693-5051

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
202 HOLMAN DR
Provider Second Line Business Practice Location Address:
POB 245
Provider Business Practice Location Address City Name:
HEADLAND
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36345-2307
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
334-693-3324
Provider Business Practice Location Address Fax Number:
334-693-5051
Provider Enumeration Date:
05/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
FLOYD
Authorized Official First Name:
STEPHEN
Authorized Official Middle Name:
W
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
334-693-3324

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 009410770 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100002571 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com