Provider Demographics
NPI:1154632321
Name:FLOYD, REBECCA ELLEN (RPH)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ELLEN
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 1:8431 GARVEY DR STE 117
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-3267
Mailing Address - Country:US
Mailing Address - Phone:919-534-1385
Mailing Address - Fax:919-534-1386
Practice Address - Street 1:8431 GARVEY DR STE 117
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-3267
Practice Address - Country:US
Practice Address - Phone:919-534-1385
Practice Address - Fax:919-534-1386
Is Sole Proprietor?:No
Enumeration Date:2010-06-23
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8648183500000X
NC18650183500000X
VA0202206926183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist