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NPI Code Detail

MEDICARE: CORNERSTONE PHARMACY LAKEWOOD, LLC

MEDICARE: CORNERSTONE PHARMACY LAKEWOOD, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336C0003XCommunity/Retail Pharmacy

General Provider Information

NPI Number : 1689927782
Entity Type Code : Organization
Provider Name (Legal Business Name) : CORNERSTONE PHARMACY LAKEWOOD, LLC
Provider Business Mailing Address
First Line : 2609 MCCAIN BLVD
Second Line :
City : NORTH LITTLE ROCK
State : AR
Zip : 72116-8013
Country : US
Telephone Number : 501-353-1984
Fax Number : 501-353-2698
Provider Business Practice Location Address
First Line : 2609 MCCAIN BLVD
Second Line :
City : NORTH LITTLE ROCK
State : AR
Zip : 72116-8013
Country : US
Telephone Number : 501-353-1984
Fax Number : 501-353-2698
Authorized Official
Title or Position : MANAGING PARTNER
Name : MR. KENNY HARRISON
Credential : PHARM D
Telephone Number : 501-580-1895
Provider Enumeration Date : 10/26/2012
Last Update Date : 08/23/2024

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Directions to “CORNERSTONE PHARMACY LAKEWOOD, LLC ” Practice Location

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