Provider Demographics
NPI:1710578174
Name:WOODRUFF, CAMDON ADEN (PHARMD)
Entity type:Individual
Prefix:
First Name:CAMDON
Middle Name:ADEN
Last Name:WOODRUFF
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 1:3220 STONEHENGE DR
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-9584
Mailing Address - Country:US
Mailing Address - Phone:501-539-8700
Mailing Address - Fax:
Practice Address - Street 1:900 S BOWMAN RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-3617
Practice Address - Country:US
Practice Address - Phone:501-219-0283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD15319183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist