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General NPI Number Information
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NPI Number | 1881757706
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Entity Type | Organization
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Legal Business Name | STONEWOOD VILLAGE PHARMACY INC
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7320 ROGERS AVE SUITE 18
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City | FORT SMITH
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State | AR
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Zip | 72903-4164
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Country | US
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Telephone | 479-452-8290
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Fax | 479-452-4304
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Provider Business Mailing Address
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Address Line | 7320 ROGERS AVE SUITE 18
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City | FORT SMITH
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State | AR
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Zip | 72903-4164
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Country | US
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Telephone | 479-452-8290
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Fax | 479-452-4304
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Authorized Official
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Title or Position | OWNER
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Name | MR. JAMES AUBRY FIELDS
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Credential | PD
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Telephone | 479-452-8290
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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 | AR13334
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License Number State | AR
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