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THOMAS HALL STARK PHARMD

>> Pharmacist >> Pharmacy Service Providers

Registrant NPI Number: 1417579772

Individual Registrant:
 THOMAS HALL STARK PHARMD
Gender: M
Not Sole Proprietor

Location and contact information for practice:
240 SLACK ST  PEA RIDGE, AR 72751-3759 US
Tel: 479-451-9008  Fax: --

Contact information for business:
1428 LE CHESNAY DR  CENTERTON, AR 72719-8805 US
Tel: 479-644-4136  Fax: --

Registration Information:
NPI: 1417579772
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y183500000XPharmacy Service Providers
Pharmacist
ARPD12270

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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