Healthcare Provider Details
I. General information
NPI: 1326277716
Provider Name (Legal Business Name): CARLY FLOYD PHARMD, PHC, AAHIVP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/07/2009
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
801 ENCINO PL NE STE A16
ALBUQUERQUE NM
87102-2640
US
IV. Provider business mailing address
800 BRADBURY DR SE STE 116
ALBUQUERQUE NM
87106-4310
US
V. Phone/Fax
- Phone: 505-272-1213
- Fax: 505-272-1352
- Phone: 505-272-1476
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | RP00007285 |
| License Number State | NM |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | 47916 |
| License Number State | TX |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1835P0018X |
| Taxonomy | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| License Number | PC00000178 |
| License Number State | NM |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: