Provider Demographics
NPI:1578237103
Name:GURLEY, CADE AUSTIN (RPH)
Entity Type:Individual
Prefix:
First Name:CADE
Middle Name:AUSTIN
Last Name:GURLEY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1375 MARKET SQUARE DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762-4984
Mailing Address - Country:US
Mailing Address - Phone:479-750-7853
Mailing Address - Fax:
Practice Address - Street 1:1375 MARKET SQUARE DR
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-4984
Practice Address - Country:US
Practice Address - Phone:479-750-7853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-06
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD15862183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist