=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346684198
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RASHIDA KING LLOYD PHARMD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/23/2013
-----------------------------------------------------
Last Update Date | 01/02/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 101 E GOODNIGHT AVE
-----------------------------------------------------
City | ARANSAS PASS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78336-1919
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 361-758-9565
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1305
-----------------------------------------------------
City | PORTLAND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78374-1185
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-246-3070
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 14772
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | RPH022043
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | PST.017367
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 42390
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------