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Ppg Store 2 Llc

Ppg Store 2 Llc is a health care provider in Fayetteville, AR. In this page you will find its mailing address, practice location, phone number, specialty etc.

physician-icon Basic Information

Practice Location 560 Gentry Blvd, Gentry, AR 72734-8576, US
Practice Location Phone479-525-6200
Practice Location Fax479-525-6168
Legal Business NamePPG STORE 2 LLC
Other Organization Name TypeDoing Business As Name
NPI ?1447619572
Entity TypeOrganization
Enumeration Date ? Feb 17, 2016
Last Update Date ? Mar 31, 2016
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).

specialty-icon Specialties & Licenses of Ppg Store 2 Llc

SpecialtySpecializationLicenseLicense State
PharmacyCommunity/Retail Pharmacy AR20833Arkansas
PharmacyCompounding Pharmacy

legacy-id-icon Legacy Provider IDs of Ppg Store 2 Llc

Provider IdIssuer StateIssuer TypeIssuer

official-icon Authorized Official of Ppg Store 2 Llc

An authorized official is an appointed official with the legal authority to make changes and/or updates to the Ppg Store 2 Llc's status and to commit the provider to fully abide by the laws and regulations relating to the National Provider Identifier (NPI).

Authorized Official Zach Holderfield
Authorized Official Title/PositionOWNER, PIC, AO
Authorized Official Phone Number870-814-0605