NPIMap

Organization Active NPI

Cornerstone Pharmacy Otter Creek LLC

  • Long Term Care Pharmacy
  • Little Rock, AR
National Provider Identifier
1174246284
Registry record updated Sep 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
CORNERSTONE PHARMACY OTTER CREEK LLC
Practice address
10320 Stagecoach Rd
Little Rock, AR 72210-5746
Phone
(501) 455-1900
Fax
(501) 455-0500
NPI assigned
Sep 22, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2022

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

Authorized official

Name
Eric Lee Shelley
Title
Pic
Phone
(501) 455-1900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

10320 Stagecoach Rd
Little Rock, AR 72210-5746

Mailing address

10320 Stagecoach Rd
Little Rock, AR 72210-5746
Phone (501) 455-1900

National Provider Directory

National Provider Directory
Tax ID family
Cornerstone Pharmacy Otter Creek LLC2 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.

NPI Registry JSON

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

{
    "created_epoch": "1663804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663804800000",
    "number": "1174246284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10320 STAGECOACH RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722105746",
            "telephone_number": "501-455-1900",
            "fax_number": "501-455-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10320 STAGECOACH RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722105746",
            "telephone_number": "501-455-1900",
            "fax_number": "501-455-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE PHARMACY OTTER CREEK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-22",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A",
        "authorized_official_last_name": "SHELLEY",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "501-455-1900"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.