Organization
CORNERSTONE PHARMACY OTTER CREEK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC LEE SHELLEY PHARMD (PIC)
(501) 455-1900
Entity
Organization
Contact information
Practice address
10320 STAGECOACH RD, LITTLE ROCK, AR 72210-5746
(501) 455-1900
(501) 455-0500
Mailing address
10320 STAGECOACH RD, LITTLE ROCK, AR 72210-5746
(501) 455-1900
(501) 455-0500
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1468892164
NPI
AR
01
—
7523000001
PTAN
AR
Enumeration date
11/18/2013
Last updated
09/22/2022
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