Provider Demographics
NPI:1780767384
Name:WHITMORE, ALISA D (PHARM D)
Entity type:Individual
Prefix:DR
First Name:ALISA
Middle Name:D
Last Name:WHITMORE
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 1:51 LEGENDS DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72210-9105
Mailing Address - Country:US
Mailing Address - Phone:501-257-2926
Mailing Address - Fax:501-257-2930
Practice Address - Street 1:2200 FORT ROOTS DR
Practice Address - Street 2:PHARMACY (119) BLDG 66 RM 144
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72114-1709
Practice Address - Country:US
Practice Address - Phone:501-257-2926
Practice Address - Fax:501-257-2930
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR08543183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist