Healthcare Provider Details

I. General information

NPI: 1255937843
Provider Name (Legal Business Name): ASHLEY LAUREN TEMPLES PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2020
Last Update Date: 12/08/2020
Certification Date: 12/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 CANAAN RD
MARSHALL AR
72650-9009
US

IV. Provider business mailing address

509 CANAAN RD
MARSHALL AR
72650-9009
US

V. Phone/Fax

Practice location:
  • Phone: 501-428-0286
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPD15420
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: