Provider Demographics
NPI:1417942731
Name:LAWS VILLAGE PHARMACY, INC.
Entity Type:Organization
Organization Name:LAWS VILLAGE PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:KORKAMES
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:479-646-5505
Mailing Address - Street 1:2504 MARKET TRCE
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72908-8676
Mailing Address - Country:US
Mailing Address - Phone:479-646-5505
Mailing Address - Fax:479-649-7535
Practice Address - Street 1:2504 MARKET TRCE
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72908-8676
Practice Address - Country:US
Practice Address - Phone:479-646-5505
Practice Address - Fax:479-649-7535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR-14576333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy