Provider Demographics
NPI:1609476175
Name:DESAI, POOJA (PHARMD)
Entity Type:Individual
Prefix:
First Name:POOJA
Middle Name:
Last Name:DESAI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:POOJA
Other - Middle Name:
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2004 S PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72764-6204
Mailing Address - Country:US
Mailing Address - Phone:479-751-4817
Mailing Address - Fax:
Practice Address - Street 1:2004 S PLEASANT ST
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72764-6204
Practice Address - Country:US
Practice Address - Phone:479-751-4817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD15068183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist