Healthcare Provider Details

I. General information

NPI: 1760172670
Provider Name (Legal Business Name): FREMAN GIRDLER PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2023
Last Update Date: 05/12/2023
Certification Date: 05/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 MUSEUM RD STE 100
CONWAY AR
72032-4761
US

IV. Provider business mailing address

50 BLUE MOUNTAIN DR
MAUMELLE AR
72113-6354
US

V. Phone/Fax

Practice location:
  • Phone: 501-932-9010
  • Fax: 501-585-9021
Mailing address:
  • Phone: 501-804-8700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPD09568
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: