Provider Demographics
NPI:1497431738
Name:CORNERSTONE PHARMACY OF BELLA VISTA LLC
Entity Type:Organization
Organization Name:CORNERSTONE PHARMACY OF BELLA VISTA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:B
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:III
Authorized Official - Credentials:PHARMD, PHD
Authorized Official - Phone:479-876-6200
Mailing Address - Street 1:1 MERCY WAY STE 50
Mailing Address - Street 2:
Mailing Address - City:BELLA VISTA
Mailing Address - State:AR
Mailing Address - Zip Code:72714-3000
Mailing Address - Country:US
Mailing Address - Phone:479-876-6200
Mailing Address - Fax:479-876-2232
Practice Address - Street 1:1 MERCY WAY STE 50
Practice Address - Street 2:
Practice Address - City:BELLA VISTA
Practice Address - State:AR
Practice Address - Zip Code:72714-3000
Practice Address - Country:US
Practice Address - Phone:479-876-6200
Practice Address - Fax:479-876-2232
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CORNERSTONE PHARMACY OF BELLA VISTA LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-06-22
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy