Wynne Medical Pharmacy of Cross County Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

06581 Issued in AR

Legal business name

WYNNE MEDICAL PHARMACY OF CROSS COUNTY INC

Doing business as

Wynne Medical Pharmacy of Cross County Inc.

Practice address

718 Falls Blvd S
Wynne, AR 72396-3514

Phone

(870) 238-8531

Fax

(870) 238-5982

NPI assigned

May 4, 2011

Last updated

Jul 21, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Leslie Johnson, PHARM D

Title

Pic

Phone

(870) 238-8531

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• WYNNE MEDICAL PHARMACY OF CROSS COUNTY INC. Doing business as

Medicare fee-for-service enrollment

Enrolled in AR2 enrollments

Enrollment records 2

Tax ID family

Wynne Medical Pharmacy of Cross County Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Wynne Medical Pharmacy of Cross County Inc

  • Long Term Care Pharmacy
  • Wynne, AR
  • NPI 1538915459
  NPD tax ID
• Wynne Medical Pharmacy of Cross County Inc

  • Community/Retail Pharmacy
  • Wynne, AR
  • NPI 1982997524
  NPD tax ID

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

{
    "created_epoch": "1304467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753056000000",
    "number": "1255623625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 757",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723960757",
            "telephone_number": "870-238-8531",
            "fax_number": "870-238-5982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 FALLS BLVD S",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723963514",
            "telephone_number": "870-238-8531",
            "fax_number": "870-238-5982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYNNE MEDICAL PHARMACY OF CROSS COUNTY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-04",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "870-238-8531",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AR",
            "license": "06581",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2130090",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WYNNE MEDICAL PHARMACY OF CROSS COUNTY INC.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wynne Healthcare Center, LLC
• Wynne Medical Clinic
• Wynne Medical Clinic
• Wynne Medical Clinic PA
• Wynne Medical Pharmacy Inc
• Wynne Medical Pharmacy of Cross County Inc
• Wynne Medical Pharmacy of Cross County Inc
• Wynne Physicians Clinic LLC
• Wynne Public Schools

• Community/Retail Pharmacy in Wynne, AR
• Providers in Wynne, 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 Jul 21, 2025; 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.