Healthcare Provider Details

I. General information

NPI: 1275283269
Provider Name (Legal Business Name): ADUSTON SPIVEY RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2022
Last Update Date: 03/24/2022
Certification Date: 03/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 AIRPORT RD, HOT SPRINGS PHARMACY
HOT SPRINGS AR
71913
US

IV. Provider business mailing address

1210 AIRPORT RD
HOT AR
71913
US

V. Phone/Fax

Practice location:
  • Phone: 501-760-2444
  • Fax: 501-760-2449
Mailing address:
  • Phone: 501-760-2444
  • Fax: 501-760-2449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPD07698
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: