Provider Demographics
NPI:1407442635
Name:STOLARZ, AMANDA J (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:J
Last Name:STOLARZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 MILLIGAN DR
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72113-7633
Mailing Address - Country:US
Mailing Address - Phone:870-200-0883
Mailing Address - Fax:
Practice Address - Street 1:1510 MILLIGAN DR
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72113-7633
Practice Address - Country:US
Practice Address - Phone:870-200-0883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-11
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD12285183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist