Healthcare Provider Details

I. General information

NPI: 1639421142
Provider Name (Legal Business Name): CYNTHIA MARIE AGUILAR PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2012
Last Update Date: 05/05/2023
Certification Date: 05/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 E WALNUT ST
PARIS AR
72855-4019
US

IV. Provider business mailing address

508 E WALNUT ST
PARIS AR
72855-4019
US

V. Phone/Fax

Practice location:
  • Phone: 479-963-6400
  • Fax: 479-963-2103
Mailing address:
  • Phone: 479-963-6400
  • Fax: 479-963-2103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number68185
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0014523
License Number StateOR
# 3
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPD16416
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: