Provider Demographics
NPI:1588383905
Name:PHOUTHAKHIO, CARINA ARUNY (PHARM D)
Entity type:Individual
Prefix:DR
First Name:CARINA
Middle Name:ARUNY
Last Name:PHOUTHAKHIO
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 1:571 BROOKE ST
Mailing Address - Street 2:
Mailing Address - City:TONTITOWN
Mailing Address - State:AR
Mailing Address - Zip Code:72762-4382
Mailing Address - Country:US
Mailing Address - Phone:479-769-4779
Mailing Address - Fax:
Practice Address - Street 1:3251 W SUNSET AVE
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-4947
Practice Address - Country:US
Practice Address - Phone:479-756-1290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD16284183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist