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General NPI Number Information
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NPI Number | 1609936897
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Entity Type | Organization
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Legal Business Name | CORNERSTONE PHARMACY, INC
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 03/19/2009
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Provider Practice Location Address
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Address Line | 1216 E STATE ROUTE 72
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City | ROLLA
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State | MO
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Zip | 65401-3938
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Country | US
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Telephone | 573-426-5700
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Fax |
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Provider Business Mailing Address
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Address Line | 1216 E STATE ROUTE 72
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City | ROLLA
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State | MO
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Zip | 65401-3938
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Country | US
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Telephone | 573-426-5700
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ERIC RICHARD SANDS
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Credential | RPH
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Telephone | 573-426-5700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2001024190
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License Number State | MO
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