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General NPI Number Information
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NPI Number | 1235907924
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Entity Type | Individual
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Provider Name | LAUREN ALEXANDRA CARROLL PHARM. D
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Gender | Female
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Dates
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Enumeration Date | 12/13/2023
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Last Update Date | 12/13/2023
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Provider Practice Location Address
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Address Line | 744 HIGHWAY 270 E
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City | MOUNT IDA
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State | AR
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Zip | 71957-8003
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Country | US
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Telephone | 870-867-3174
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Fax |
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Provider Business Mailing Address
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Address Line | 154 GARNER MOUNTAIN RD
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City | AMITY
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State | AR
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Zip | 71921-9014
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PD11382
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License Number State | AR
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