Provider Demographics
NPI:1033956495
Name:DESAI, DARSHANKUMAR (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DARSHANKUMAR
Middle Name:
Last Name:DESAI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:DARSHAN
Other - Middle Name:
Other - Last Name:DESAI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:16600 INTERSTATE 30 N
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72019-3692
Mailing Address - Country:US
Mailing Address - Phone:918-219-7787
Mailing Address - Fax:
Practice Address - Street 1:3220 N REYNOLDS RD
Practice Address - Street 2:
Practice Address - City:BRYANT
Practice Address - State:AR
Practice Address - Zip Code:72022-9039
Practice Address - Country:US
Practice Address - Phone:501-847-0803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-12
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD17057183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist