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NPI Code Detail

MEDICARE: SHARON LATHAN PHARMACIST

MEDICARE: SHARON LATHAN PHARMACIST
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
1183500000XPharmacistPD08024AR

General Provider Information

NPI Number : 1730465592
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHARON LATHAN PHARMACIST
Provider Business Mailing Address
First Line : 44 HUNTINGTON RD
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72227-2321
Country : US
Telephone Number : 870-723-2868
Fax Number :
Provider Business Practice Location Address
First Line : 15500 CHENAL PKWY
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72211-2018
Country : US
Telephone Number : 501-217-3872
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2011
Last Update Date : 10/25/2011

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