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General NPI Number Information
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NPI Number | 1417942731
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Entity Type | Organization
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Legal Business Name | LAWS VILLAGE PHARMACY, INC.
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Dates
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Enumeration Date | 09/13/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2504 MARKET TRCE
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City | FORT SMITH
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State | AR
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Zip | 72908-8676
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Country | US
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Telephone | 479-646-5505
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Fax | 479-649-7535
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Provider Business Mailing Address
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Address Line | 2504 MARKET TRCE
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City | FORT SMITH
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State | AR
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Zip | 72908-8676
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Country | US
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Telephone | 479-646-5505
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Fax | 479-649-7535
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Authorized Official
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Title or Position | OWNER
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Name | MR. JOSEPH KORKAMES
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Credential | R.PH
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Telephone | 479-646-5505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | AR-14576
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License Number State | AR
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