1023606621 NPI number — MRS. SARAH ALAINE RHYNE LEDFORD PHARMD.

Table of content: MRS. SARAH ALAINE RHYNE LEDFORD PHARMD. (NPI 1023606621)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023606621 NPI number — MRS. SARAH ALAINE RHYNE LEDFORD PHARMD.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEDFORD
Provider First Name:
SARAH
Provider Middle Name:
ALAINE RHYNE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RHYNE
Provider Other First Name:
SARAH
Provider Other Middle Name:
ALAINE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1023606621
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/08/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1450 E ZION RD STE 1
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FAYETTEVILLE
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72703-4988
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
479-444-7200
Provider Business Mailing Address Fax Number:
479-444-7205

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1450 E ZION RD STE 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FAYETTEVILLE
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72703-4988
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
479-444-7200
Provider Business Practice Location Address Fax Number:
479-444-7205
Provider Enumeration Date:
01/08/2021

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  PD11634 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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