Organization Name: | CORNERSTONE PHARMACY OF BELLA VISTA LLC |
NPI Number: | 1043546799 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JAMES GRAHAM (CEO, OWNER) |
Mailing Address: | 1 Mercy Way Ste 50 Bella Vista |
State: | AR US |
Postal Code: | 727143000 |
Phone Number: | 4798766200 |
Fax Number: | 4798762232 |
NPI Enumeration Date: | 10/29/2009 |
NPI Last Update Date: | 12/17/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 3336C0004X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Pharmacy |
Taxonomy Specialization: | Compounding Pharmacy |
Taxonomy Definition: | A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner |