Provider Demographics
NPI:1871131177
Name:VERDARIS, MARIA S
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:S
Last Name:VERDARIS
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 1:1100 E ROOSEVELT RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72206-2415
Mailing Address - Country:US
Mailing Address - Phone:501-375-5645
Mailing Address - Fax:501-375-5650
Practice Address - Street 1:1100 E ROOSEVELT RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72206-2415
Practice Address - Country:US
Practice Address - Phone:501-375-5645
Practice Address - Fax:501-375-5650
Is Sole Proprietor?:No
Enumeration Date:2019-12-17
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD08816183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist