Most Relevant Information
Provider Data
| NPI Number: | 1003433186 |
| Provider Name: | GRANT ELLIS WOMACK PHARMD |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | PD15369 |
Most Important Dates
| Enumeration Date: | 07/06/2020 |
| Last Updated: | 07/06/2020 |
Provider Practice Location
2515 E HUNTSVILLE RD
FAYETTEVILLE
AR
727017329
Practice Location Phone/Fax
| Phone: | 4794433411 |
| Fax: |
Provider Mailing Location
2515 E HUNTSVILLE RD
FAYETTEVILLE
AR
727017329
Provider Mailing Phone/Fax
| Phone: | 4794433411 |
| Fax: |