Basic Information
| Provider Information | |||||||||
| NPI: | 1922370741 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LLOYD | ||||||||
| FirstName: | WALTER | ||||||||
| MiddleName: | GERARD | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | PHARMD | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 740 | ||||||||
| Address2: | |||||||||
| City: | CHINLE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 865030740 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2052426006 | ||||||||
| FaxNumber: | 9286747849 | ||||||||
| Practice Location | |||||||||
| Address1: | PO BOX PH | ||||||||
| Address2: | |||||||||
| City: | CHINLE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 865038000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9286747502 | ||||||||
| FaxNumber: | 9286747849 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/09/2012 | ||||||||
| LastUpdateDate: | 12/06/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 42307 | TX | Y | Pharmacy Service Providers | Pharmacist | 183500000X | 14599 | AL | N | Pharmacy Service Providers | Pharmacist | 183500000X | 17098 | LA | N | Pharmacy Service Providers | Pharmacist | 183500000X | 444496 | PA | N | Pharmacy Service Providers | Pharmacist | 1835P1200X | 3153899 | AZ | N | Pharmacy Service Providers | Pharmacist | Pharmacotherapy | 183500000X | S020997 | AZ | N | Pharmacy Service Providers | Pharmacist | 183500000X | RP00008317 | NM | N | Pharmacy Service Providers | Pharmacist |
No ID Information.