Provider Demographics
NPI:1114184553
Name:BROCK, SABRINA JOY (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:SABRINA
Middle Name:JOY
Last Name:BROCK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:SABRINA
Other - Middle Name:JOY
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:10802 EXECUTIVE CENTER DR STE 100
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-4377
Mailing Address - Country:US
Mailing Address - Phone:501-257-5188
Mailing Address - Fax:
Practice Address - Street 1:4300 W 7TH ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5446
Practice Address - Country:US
Practice Address - Phone:501-257-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-22
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD-09904183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist