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.
|Practice Location|| 560 Gentry Blvd, Gentry, AR 72734-8576, US |
|Practice Location Phone||479-525-6200|
|Practice Location Fax||479-525-6168|
|Legal Business Name||PPG STORE 2 LLC|
|Other Organization Name||CORNERSTONE PHARMACY GENTRY|
|Other Organization Name Type||Doing Business As Name|
|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).
Specialties & Licenses of Ppg Store 2 Llc
|Specialty||Provider Type||Specialization||License||License State|
|Pharmacy||Suppliers||Community/Retail Pharmacy ||AR20833||Arkansas|
|Pharmacy||Suppliers||Compounding Pharmacy |
Legacy Provider IDs of Ppg Store 2 Llc
|Provider Id||Issuer State||Issuer Type||Issuer|
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/Position||OWNER, PIC, AO|
|Authorized Official Phone Number||870-814-0605|