Stacy E Cooper, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

PD10812 Issued in AR

Practice address

411 Falls Blvd S
Wynne, AR 72396

Phone

(870) 238-8511

NPI assigned

Nov 5, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wynne Apothecary Inc

  • Community/Retail Pharmacy
  • Wynne, AR
  • NPI 1508859737
  NPD Authorized official
• Wynne Apothecary Inc

  • Long Term Care Pharmacy
  • Wynne, AR
  • NPI 1891576286
  NPD Authorized official
• Cornerstone Pharmacy Inc

  • Community/Retail Pharmacy
  • Little Rock, AR
  • NPI 1437228756
  NPD (past)
• Cornerstone Pharmacy Inc

  • Long Term Care Pharmacy
  • Little Rock, AR
  • NPI 1699565143
  NPD (past)

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

{
    "created_epoch": "1225843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1295989176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 FALLS BLVD S",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723963501",
            "telephone_number": "870-238-8511",
            "fax_number": "870-238-2135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 FALLS BLVD S",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "72396",
            "telephone_number": "870-238-8511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "STACY",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-05",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "PD10812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE NUMBER",
            "identifier": "PD10812",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kerry K Childers, O.D.
• Madison Grace Coats
• Valisya Coleman, LCSW
• Kimberly Collins
• Tiffani Lynette Collins, COTA/L
• Coopers Anesthesia Services
• Caleb Cothern
• Counseling Consultants
• Counseling Services of Eastern Arkansas
• Counseling Services of Eastern Arkansas

• All providers in Wynne, AR
• Pharmacist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.