Healthcare Provider Details

I. General information

NPI: 1851129571
Provider Name (Legal Business Name): JENNIFER MICHELLE GRIFFIN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2024
Last Update Date: 07/24/2024
Certification Date: 07/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 E GERMAN LN
CONWAY AR
72032-4555
US

IV. Provider business mailing address

2025 EDITH CIR
CONWAY AR
72032-5000
US

V. Phone/Fax

Practice location:
  • Phone: 501-329-3733
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPD17060
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: