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General NPI Number Information
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NPI Number | 1477154391
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Entity Type | Individual
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Provider Name | MARGARET SORRELLS R.PH.
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Gender | Female
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Dates
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Enumeration Date | 11/06/2020
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Last Update Date | 11/06/2020
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Provider Practice Location Address
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Address Line | 3909 N MALL AVE ATTN:PHARMACY
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City | FAYETTEVILLE
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State | AR
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Zip | 72703
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Country | US
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Telephone | 479-443-9267
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 661
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City | FARMINGTON
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State | AR
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Zip | 72730-0661
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Country | US
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Telephone | 479-841-1156
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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 | PD07411
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License Number State | AR
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