Provider Demographics
NPI:1447787114
Name:CORNERSTONE PHARMACY SERVICES, LLC.
Entity Type:Organization
Organization Name:CORNERSTONE PHARMACY SERVICES, LLC.
Other - Org Name:CORNERSTONE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:TROY
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:760-641-4796
Mailing Address - Street 1:39575 WASHINGTON ST STE 103
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92211-4152
Mailing Address - Country:US
Mailing Address - Phone:760-200-0220
Mailing Address - Fax:760-200-0990
Practice Address - Street 1:39575 WASHINGTON ST STE 103
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92211-4152
Practice Address - Country:US
Practice Address - Phone:760-200-0220
Practice Address - Fax:760-200-0990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-12
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55581333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy