Provider Demographics
NPI:1376857987
Name:HEDDEN, CASEY WARD (PHARMD)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:WARD
Last Name:HEDDEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 217
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:AR
Mailing Address - Zip Code:72150-0217
Mailing Address - Country:US
Mailing Address - Phone:870-942-5121
Mailing Address - Fax:870-942-2592
Practice Address - Street 1:821 N ROCK ST
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:AR
Practice Address - Zip Code:72150-7623
Practice Address - Country:US
Practice Address - Phone:870-942-5121
Practice Address - Fax:870-942-2592
Is Sole Proprietor?:No
Enumeration Date:2010-08-06
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD11118183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist