Healthcare Provider Details

I. General information

NPI: 1528656394
Provider Name (Legal Business Name): KRISTINA ABLES PHARMACIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2021
Last Update Date: 01/06/2021
Certification Date: 12/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

344 SOUTH LEE ST HWY 167S
HAMPTON AR
71744-7174
US

IV. Provider business mailing address

PO BOX 719
HAMPTON AR
71744-0719
US

V. Phone/Fax

Practice location:
  • Phone: 870-798-4247
  • Fax: 870-798-4934
Mailing address:
  • Phone: 870-798-4247
  • Fax: 870-798-4934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPD10151
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: