Provider Demographics
NPI:1982857116
Name:STEWART, IRMA S
Entity Type:Individual
Prefix:MS
First Name:IRMA
Middle Name:S
Last Name:STEWART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9124 HIGHWAY 365 S
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72206-7402
Mailing Address - Country:US
Mailing Address - Phone:501-897-4917
Mailing Address - Fax:
Practice Address - Street 1:9124 HIGHWAY 365 S
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72206-7402
Practice Address - Country:US
Practice Address - Phone:501-897-4917
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-31
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician