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General NPI Number Information
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NPI Number | 1447787114
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Entity Type | Organization
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Legal Business Name | CORNERSTONE PHARMACY SERVICES, LLC.
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Dates
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Enumeration Date | 05/12/2017
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Last Update Date | 05/12/2017
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Provider Practice Location Address
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Address Line | 39575 WASHINGTON ST STE 103
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City | PALM DESERT
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State | CA
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Zip | 92211-4152
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Country | US
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Telephone | 760-200-0220
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Fax | 760-200-0990
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Provider Business Mailing Address
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Address Line | 39575 WASHINGTON ST STE 103
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City | PALM DESERT
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State | CA
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Zip | 92211-4152
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Country | US
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Telephone | 760-200-0220
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Fax | 760-200-0990
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Authorized Official
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Title or Position | OWNER
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Name | DR. GREGORY TROY COLLINS
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Credential | PHARMD.
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Telephone | 760-641-4796
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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 | 55581
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License Number State | CA
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