Provider Demographics
NPI:1639068836
Name:SEAL, GARRETT WADE (PHARMD)
Entity type:Individual
Prefix:
First Name:GARRETT
Middle Name:WADE
Last Name:SEAL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4307 E BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72117-4124
Mailing Address - Country:US
Mailing Address - Phone:501-945-3264
Mailing Address - Fax:
Practice Address - Street 1:4307 E BROADWAY ST
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117-4124
Practice Address - Country:US
Practice Address - Phone:501-945-3264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD17395183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist