Provider Demographics
NPI:1548869977
Name:OGUH, JULIANA
Entity type:Individual
Prefix:
First Name:JULIANA
Middle Name:
Last Name:OGUH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8110 ALVIN LN
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72227-3927
Mailing Address - Country:US
Mailing Address - Phone:832-567-5865
Mailing Address - Fax:
Practice Address - Street 1:1155 HWY 65 NORTH
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032-7203
Practice Address - Country:US
Practice Address - Phone:501-329-0023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-16
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD15359183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARPD15359OtherARKANSAS STATE BOARD OF PHARMACY