Healthcare Provider Details

I. General information

NPI: 1508563255
Provider Name (Legal Business Name): TAYLOR LLOYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2023
Last Update Date: 08/07/2024
Certification Date: 08/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 N MACOMB ST STE 112
MONROE MI
48162-2904
US

IV. Provider business mailing address

514 MARITIME CT
PERRYSBURG OH
43551-1565
US

V. Phone/Fax

Practice location:
  • Phone: 419-291-2010
  • Fax: 419-480-8715
Mailing address:
  • Phone: 419-889-8098
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03442706
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: