Provider Demographics
NPI:1184991358
Name:TAYLOR, LORA JOHNSON (PHARM D)
Entity type:Individual
Prefix:
First Name:LORA
Middle Name:JOHNSON
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 BLUE BIRD LN
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-9445
Mailing Address - Country:US
Mailing Address - Phone:501-278-7036
Mailing Address - Fax:501-279-1334
Practice Address - Street 1:200 E RACE AVE
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-4330
Practice Address - Country:US
Practice Address - Phone:501-279-1125
Practice Address - Fax:501-279-1334
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-16
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD07255183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist