Individual
THOMAS E WINNINGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PD
Contact information
Practice address
232 W MAIN ST, BRADFORD, AR 72020-0130
(501) 344-2763
(501) 344-8383
Mailing address
PO BOX 130, 232 W MAIN ST, BRADFORD, AR 72020-0130
(501) 344-2763
(501) 344-8383
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PD05283
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100499407
—
AR
01
—
118686716
MEDICAID DME
AR
Enumeration date
11/04/2006
Last updated
06/28/2012
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