Organization Active NPI

Cornerstone Pharmacy Services, LLC.

  • Pharmacy
  • Palm Desert, CA
National Provider Identifier
1447787114
Registry record updated May 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
55581 Issued in CA
Legal business name
CORNERSTONE PHARMACY SERVICES, LLC.
Doing business as
Cornerstone Pharmacy
Practice address
39575 Washington St Ste 103
Palm Desert, CA 92211-4152
Phone
(760) 200-0220
Fax
(760) 200-0990
NPI assigned
May 12, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2017

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

Authorized official

Name
Dr. Gregory Troy Collins, PHARMD.NPI 1992232748
Title
Owner
Phone
(760) 641-4796

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 55581 CA Primary

Addresses

Primary practice location

39575 Washington St Ste 103
Palm Desert, CA 92211-4152

Mailing address

39575 Washington St Ste 103
Palm Desert, CA 92211-4152
Phone (760) 200-0220

Other names 1

  • Cornerstone Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170717003460 CA Part B Supplier - Mass Immunization (Roster Biller Only) 4385914852 Practice locations: Palm Desert, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1494547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494547200000",
    "number": "1447787114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39575 WASHINGTON ST STE 103",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922114152",
            "telephone_number": "760-200-0220",
            "fax_number": "760-200-0990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39575 WASHINGTON ST STE 103",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922114152",
            "telephone_number": "760-200-0220",
            "fax_number": "760-200-0990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE PHARMACY SERVICES, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-12",
        "last_updated": "2017-05-12",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "TROY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "760-641-4796",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "55581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cornerstone Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palm Desert, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2017; 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.