Provider Demographics
NPI:1013046317
Name:BRYANT, BRENDA (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:
Last Name:BRYANT
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18876 ALLRED RD
Mailing Address - Street 2:
Mailing Address - City:GRIFFITHVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72060-7922
Mailing Address - Country:US
Mailing Address - Phone:870-256-3733
Mailing Address - Fax:
Practice Address - Street 1:3509 E RACE AVE
Practice Address - Street 2:WAL-MART PHARMACY
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-6202
Practice Address - Country:US
Practice Address - Phone:501-268-4949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR07834183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist