Provider Demographics
NPI:1811982739
Name:RAUSHER, LLOYD L (PD)
Entity type:Individual
Prefix:MR
First Name:LLOYD
Middle Name:L
Last Name:RAUSHER
Suffix:
Gender:M
Credentials:PD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1153
Mailing Address - Street 2:114 NO 26TH
Mailing Address - City:OZARK
Mailing Address - State:AR
Mailing Address - Zip Code:72949-1153
Mailing Address - Country:US
Mailing Address - Phone:479-667-2425
Mailing Address - Fax:479-667-1270
Practice Address - Street 1:500 W COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:AR
Practice Address - Zip Code:72949-3112
Practice Address - Country:US
Practice Address - Phone:479-667-2101
Practice Address - Fax:479-667-1270
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR5385183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist