Cobbs Westside Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

AR00907 Issued in AR

Legal business name

COBBS WESTSIDE PHARMACY INC

Doing business as

Cobbs Westside Pharmacy Inc

Practice address

108 Skyline Dr
Ste B
Russellville, AR 72801-3362

Phone

(479) 968-7180

Fax

(479) 967-0884

NPI assigned

May 4, 2006

Organization subpart

No

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

Authorized official

Name

Dr. William John Cobb, PHARMDNPI 1356975890

Title

Pharmacist

Phone

(479) 968-7180

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• COBBS WESTSIDE PHARMACY INC Doing business as

Medicare fee-for-service enrollment

Enrolled in AR2 enrollments

Enrollment records 2

Tax ID family

Cobbs Westside Pharmacy Inc2 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.

• Cobbs Westside Pharmacy Inc

  • Long Term Care Pharmacy
  • Russellville, AR
  • NPI 1811689938
  NPD tax ID

Practitioners 1

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

• William John Cobb, PHARMD

  • Pharmacist
  • Russellville, AR
  • NPI 1356975890
  NPD Authorized official

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582502400000",
    "number": "1457309148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 SKYLINE DR",
            "address_2": "STE B",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728013362",
            "telephone_number": "479-968-7180",
            "fax_number": "479-967-0884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 SKYLINE DR",
            "address_2": "STE B",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728013362",
            "telephone_number": "479-968-7180",
            "fax_number": "479-967-0884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COBBS WESTSIDE PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-04",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A",
        "authorized_official_last_name": "COBB",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "479-968-7180",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AR",
            "license": "AR00907",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "160234407",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1992803",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COBBS WESTSIDE PHARMACY INC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "COBBS WESTSIDE PHARMACY INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hollie Clark
• Landree Gwen Clark, QBHP-D
• Joe Cloud, M.D.
• CN Anesthesia Inc
• William John Cobb, PHARMD
• Cobbs Westside Pharmacy Inc
• Mark A Coffman, LPC, LADAC
• Tonya Denise Coffman, MHPP
• Dustin Parker Cole
• Leanna R Colindres

• Community/Retail Pharmacy in Russellville, AR
• Providers in Russellville, 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 24, 2020; 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.