Provider Demographics
NPI:1760172670
Name:GIRDLER, FREMAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:FREMAN
Middle Name:
Last Name:GIRDLER
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 1:50 BLUE MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:MAUMELLE
Mailing Address - State:AR
Mailing Address - Zip Code:72113-6354
Mailing Address - Country:US
Mailing Address - Phone:501-804-8700
Mailing Address - Fax:
Practice Address - Street 1:1500 MUSEUM RD STE 100
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032-4761
Practice Address - Country:US
Practice Address - Phone:501-932-9010
Practice Address - Fax:501-585-9021
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-12
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD09568183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist