Provider Demographics
NPI:1699358622
Name:CALDWELL, JARED (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JARED
Middle Name:
Last Name:CALDWELL
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 1:916 HARRELL ST N
Mailing Address - Street 2:
Mailing Address - City:WYNNE
Mailing Address - State:AR
Mailing Address - Zip Code:72396-2230
Mailing Address - Country:US
Mailing Address - Phone:870-588-7182
Mailing Address - Fax:
Practice Address - Street 1:2307 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:FORREST CITY
Practice Address - State:AR
Practice Address - Zip Code:72335-1800
Practice Address - Country:US
Practice Address - Phone:870-581-9029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-28
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD14330183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist