Cornerstone Pharmacy Jacksonville LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

AR20848 Issued in AR

Legal business name

CORNERSTONE PHARMACY JACKSONVILLE LLC

Doing business as

Cornerstone Pharmacy Jacksonville

Practice address

315 S James St
Jacksonville, AR 72076-4315

Phone

(501) 983-4249

Fax

(501) 983-4643

NPI assigned

Sep 7, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

T F Kenneth Harrison

Title

Owner/President/Ao

Phone

(501) 580-1895

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Cornerstone Pharmacy Jacksonville Doing business as

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Tax ID family

Cornerstone Pharmacy Jacksonville2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Cornerstone Pharmacy Jacksonville LLC

  • Long Term Care Pharmacy
  • Jacksonville, AR
  • NPI 1609573815
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1473206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675814400000",
    "number": "1083161038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 S JAMES ST",
            "city": "JACKSONVILLE",
            "state": "AR",
            "postal_code": "720764315",
            "telephone_number": "501-983-4249",
            "fax_number": "501-983-4643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 S JAMES ST",
            "city": "JACKSONVILLE",
            "state": "AR",
            "postal_code": "720764315",
            "telephone_number": "501-983-4249",
            "fax_number": "501-983-4643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE PHARMACY JACKSONVILLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-07",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "T F KENNETH",
        "authorized_official_title_or_position": "OWNER/PRESIDENT/AO",
        "authorized_official_telephone_number": "501-580-1895"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AR",
            "license": "AR20848",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2164046",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cornerstone Pharmacy Jacksonville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• James Marion Cooper, D.D.S.
• Jordan Todd Cooper, D.D.S.
• Tammy M Copeland, CRNA
• Brooklyn Cordel
• Cornerstone Caregiving East LLC
• Cornerstone Pharmacy Jacksonville LLC
• Laron Michelle Couch, BA, MHPP
• Counseling Services of Jacksonville PA
• Shelby Leanne Cowger, M.S. CCC SLP
• Courtney Beth Cowling, OTR/L

• Community/Retail Pharmacy in Jacksonville, AR
• Providers in Jacksonville, AR by specialty
• Community/Retail Pharmacy in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.