Provider Demographics
NPI:1114273950
Name:CORNERSTONE PHARMACY
Entity Type:Organization
Organization Name:CORNERSTONE PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KUMI
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIMPONG
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:214-557-8102
Mailing Address - Street 1:2707 BOLTON BOONE DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-2076
Mailing Address - Country:US
Mailing Address - Phone:972-283-4440
Mailing Address - Fax:
Practice Address - Street 1:2707 BOLTON BOONE DR
Practice Address - Street 2:SUITE 101
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-2076
Practice Address - Country:US
Practice Address - Phone:972-283-4440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-30
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX281493336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy