Provider Demographics
NPI:1457076960
Name:GREENE, ERIN B (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:B
Last Name:GREENE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21019 HIGHWAY 167 STE 100
Mailing Address - Street 2:
Mailing Address - City:HENSLEY
Mailing Address - State:AR
Mailing Address - Zip Code:72065-8154
Mailing Address - Country:US
Mailing Address - Phone:501-486-4100
Mailing Address - Fax:501-486-4101
Practice Address - Street 1:21019 HIGHWAY 167 STE 100
Practice Address - Street 2:
Practice Address - City:HENSLEY
Practice Address - State:AR
Practice Address - Zip Code:72065-8154
Practice Address - Country:US
Practice Address - Phone:501-486-4100
Practice Address - Fax:501-486-4101
Is Sole Proprietor?:No
Enumeration Date:2022-10-06
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD09708183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist