Healthcare Provider Details

I. General information

NPI: 1598751562
Provider Name (Legal Business Name): UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2005
Last Update Date: 07/03/2024
Certification Date: 07/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 W MARKHAM ST SLOT 547-10
LITTLE ROCK AR
72205-7101
US

IV. Provider business mailing address

4301 W MARKHAM ST SLOT 547-10
LITTLE ROCK AR
72205-7101
US

V. Phone/Fax

Practice location:
  • Phone: 501-686-5530
  • Fax: 501-686-5055
Mailing address:
  • Phone: 501-686-5530
  • Fax: 501-686-5055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberAR04246
License Number StateAR

VIII. Authorized Official

Name: AMANDA D GEORGE
Title or Position: ASSOC VC FOR CLINICAL FINANCE
Credential:
Phone: 501-686-5670