Provider Demographics
NPI:1629353032
Name:STANLEY, PEGGY LEE (RPH)
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:LEE
Last Name:STANLEY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 QUAIL CREEK RD
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901-7307
Mailing Address - Country:US
Mailing Address - Phone:501-623-7582
Mailing Address - Fax:501-623-4903
Practice Address - Street 1:3631 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6404
Practice Address - Country:US
Practice Address - Phone:501-623-1998
Practice Address - Fax:501-623-4903
Is Sole Proprietor?:No
Enumeration Date:2011-10-17
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD07002183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist