NPIMap

Organization Active NPI

Wynne Medical Pharmacy of Cross County Inc

  • Long Term Care Pharmacy
  • Wynne, AR
National Provider Identifier
1538915459
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
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
Apr 30, 2024
Last updated
Apr 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Authorized official

Name
Dr. Leslie A Johnson
Title
Pharmacist/Owner
Phone
(870) 238-8531

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X NU Primary

Addresses

Primary practice location

718 Falls Blvd S
Wynne, AR 72396-3514

Mailing address

718 Falls Blvd S
Wynne, AR 72396-3514
Phone (870) 238-8531

National Provider Directory

National Provider Directory
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.

Locations

718 Falls Blvd S
Wynne, AR 72396
Phone (870) 238-8531

NPI Registry JSON

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

{
    "created_epoch": "1714435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714435200000",
    "number": "1538915459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "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"
        },
        {
            "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": "2024-04-30",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHARMACIST/OWNER",
        "authorized_official_telephone_number": "870-238-8531",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynne, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; 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.