MEDICARE: REBECCA DIANE WAHRMUND PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PD15793	AR

General Provider Information

NPI Number	:	1104496157
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA DIANE WAHRMUND PHARM.D.

Provider Business Mailing Address
First Line	:	11 WARHMUND RD
Second Line	:
City	:	SPRINGFIELD
State	:	AR
Zip	:	72157-9628
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4300 W 7TH ST
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72205-5446
Country	:	US
Telephone Number	:	501-208-6493
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2021
Last Update Date	:	06/30/2021

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