Healthcare Provider Details

I. General information

NPI: 1457402349
Provider Name (Legal Business Name): GALEN WAYNE PERKINS R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 10/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7612 CANTRELL RD
LITTLE ROCK AR
72227-3320
US

IV. Provider business mailing address

116 ONEIDA WAY
MAUMELLE AR
72113-5872
US

V. Phone/Fax

Practice location:
  • Phone: 501-258-4399
  • Fax: 501-227-0714
Mailing address:
  • Phone: 501-258-4399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2000156307
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number11746
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number34526
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1-14424
License Number StateKS
# 5
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPD 10757
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: