Healthcare Provider Details

I. General information

NPI: 1932709334
Provider Name (Legal Business Name): WENDY CAROL LANGSTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2020
Last Update Date: 10/27/2020
Certification Date: 10/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 ALBERT PIKE RD
HOT SPRINGS AR
71913-4020
US

IV. Provider business mailing address

1601 ALBERT PIKE RD
HOT SPRINGS AR
71913-4020
US

V. Phone/Fax

Practice location:
  • Phone: 501-624-0142
  • Fax: 501-624-4012
Mailing address:
  • Phone: 501-624-0142
  • Fax: 501-624-4012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPST16344
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPD08573
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: