Organization
PPG STORE 3, LLC
Active
Other names
Cornerstone Pharmacy Markham, Heartland Pharmacy Markham
Organization subpart
No
Provider details
NPI number
Authorized official
ZACH HOLDERFIELD PHARMD (OWNER, AO)
(870) 814-0605
Entity
Organization
Contact information
Practice address
11414 W MARKHAM STREET, LITTLE ROCK, AR 72703
(501) 904-4299
(501) 904-4298
Mailing address
11414 W MARKHAM STREET, SUITE D, LITTLE ROCK, AR 72703
(501) 904-4299
(501) 904-4298
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
AR20840
AR
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2159147
PK
—
Enumeration date
03/30/2016
Last updated
07/21/2022
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