Healthcare Provider Details

I. General information

NPI: 1942162490
Provider Name (Legal Business Name): MIRANDA LAMB PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1155 HIGHWAY 65 N
CONWAY AR
72032-3524
US

IV. Provider business mailing address

459 LONG BRANCH LN
BEE BRANCH AR
72013-9355
US

V. Phone/Fax

Practice location:
  • Phone: 501-329-1592
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPD17603
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: