Provider Demographics
NPI:1508578030
Name:CORNERSTONE PHARMACY AT CHENAL LLC
Entity Type:Organization
Organization Name:CORNERSTONE PHARMACY AT CHENAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AUBREY
Authorized Official - Middle Name:ZIMMER
Authorized Official - Last Name:HARTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-821-2300
Mailing Address - Street 1:16115 SAINT VINCENT WAY STE 120
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-3001
Mailing Address - Country:US
Mailing Address - Phone:501-821-2300
Mailing Address - Fax:501-821-7297
Practice Address - Street 1:16115 SAINT VINCENT WAY STE 120
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-3001
Practice Address - Country:US
Practice Address - Phone:501-821-2300
Practice Address - Fax:501-821-7297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-15
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy