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Individual

AUSTIN GILBREATH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
970D ASH FLAT DR, ASH FLAT, AR 72513-9533
(870) 994-7377
(870) 994-7399
Mailing address
PO BOX 278, ASH FLAT, AR 72513-0278
(870) 994-7377
(870) 994-7399

Taxonomy

Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
AR01531
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100176407
AR
Enumeration date
06/05/2019
Last updated
06/05/2019
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