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General NPI Number Information
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NPI Number | 1699376772
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Entity Type | Individual
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Provider Name | BRANDON DARNELL APPLEWHITE
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Gender | Male
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Dates
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Enumeration Date | 11/04/2020
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Last Update Date | 11/04/2020
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Provider Practice Location Address
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Address Line | WALMART 205 DEADRICK RD
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City | FORREST CITY
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State | AR
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Zip | 72235
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Country | US
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Telephone | 870-633-0465
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Fax | 870-630-0370
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Provider Business Mailing Address
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Address Line | 16413 HIGHWAY 70
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City | BRINKLEY
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State | AR
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Zip | 72021-7039
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Country | US
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Telephone | 501-766-3690
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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 | PD11440
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License Number State | AR
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