Provider Demographics
NPI:1841888542
Name:BURROW, JOSEPH TODD (PHARM D)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:TODD
Last Name:BURROW
Suffix:
Gender:M
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:PO BOX 248
Mailing Address - Street 2:
Mailing Address - City:BEEBE
Mailing Address - State:AR
Mailing Address - Zip Code:72012-0248
Mailing Address - Country:US
Mailing Address - Phone:501-882-5425
Mailing Address - Fax:501-882-7147
Practice Address - Street 1:45 HIGHWAY 64 W
Practice Address - Street 2:
Practice Address - City:BEEBE
Practice Address - State:AR
Practice Address - Zip Code:72012-9500
Practice Address - Country:US
Practice Address - Phone:501-882-5425
Practice Address - Fax:501-882-7147
Is Sole Proprietor?:No
Enumeration Date:2021-01-07
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD09166183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR100126407Medicaid