Cornerstone Pharmacy Kennett

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

2014012293 Issued in MO

Legal business name

CORNERSTONE PHARMACY KENNETT

Practice address

123 1St St
Kennett, MO 63857-2051

Phone

(573) 888-9094

Fax

(573) 888-5946

NPI assigned

Apr 14, 2014

Organization subpart

No

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

Authorized official

Name

Christopher Scott

Title

Manager

Phone

(573) 888-9094

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Cornerstone Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in MO2 enrollments

Enrollment records 2

Tax ID family

Cornerstone Pharmacy Kennett 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.

• Cornerstone Pharmacy Kennett, LLC

  • Long Term Care Pharmacy
  • Kennett, MO
  • NPI 1003668807
  NPD tax ID

Practitioners 1

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

• Justin Garner, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Kennett, MO
  • NPI 1831848332
  NPD

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

{
    "created_epoch": "1397433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413331200000",
    "number": "1497174825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 1ST ST",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638572051",
            "telephone_number": "573-888-9094",
            "fax_number": "573-888-5946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 1ST ST",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638572051",
            "telephone_number": "573-888-9094",
            "fax_number": "573-888-5946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE PHARMACY KENNETT",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-14",
        "last_updated": "2014-10-15",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "573-888-9094"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MO",
            "license": "2014012293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2145605",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497174825",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cornerstone Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jane Elizabeth Cook, LCSW
• Kayla Cook
• Dawn Coolbaugh
• Grant Cooley-Smith
• Nancy Beth Copeland
• Cornerstone Pharmacy Kennett, LLC
• Christy Lynn Coronado
• Kathleen Cosby, LPN
• Cotton Boll Handicapped Housing
• Cotton Boll Handicapped Housing Inc.

• Community/Retail Pharmacy in Kennett, MO
• Providers in Kennett, MO by specialty
• Community/Retail Pharmacy in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2014; 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.