Healthcare Provider Details

I. General information

NPI: 1629377742
Provider Name (Legal Business Name): CORNERSTONE SPECIALTY PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2011
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 E ZION RD STE 1
FAYETTEVILLE AR
72703-4988
US

IV. Provider business mailing address

1450 E ZION RD STE 1
FAYETTEVILLE AR
72703-4988
US

V. Phone/Fax

Practice location:
  • Phone: 479-444-7200
  • Fax: 479-444-7205
Mailing address:
  • Phone: 479-444-7200
  • Fax: 479-444-7205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberAR20645
License Number StateAR

VIII. Authorized Official

Name: ZACH HOLDERFIELD
Title or Position: PARTNER
Credential: PHARMD
Phone: 479-444-7200