Provider Demographics
NPI:1982263141
Name:YORK, DARLA (PD)
Entity Type:Individual
Prefix:
First Name:DARLA
Middle Name:
Last Name:YORK
Suffix:
Gender:F
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 940
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:AR
Mailing Address - Zip Code:72576-0940
Mailing Address - Country:US
Mailing Address - Phone:870-895-7455
Mailing Address - Fax:870-895-3784
Practice Address - Street 1:502 HIGHWAY 62 W
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:AR
Practice Address - Zip Code:72576-8400
Practice Address - Country:US
Practice Address - Phone:870-895-7455
Practice Address - Fax:870-895-3784
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD07468183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist