Copper Bend Pharmacy, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

054008430 Issued in IL

Legal business name

COPPER BEND PHARMACY, INC

Doing business as

Copper Bend Pharmacy Inc

Practice address

2900 Frank Scott Pkwy W
Ste 920-B
Belleville, IL 62223-5000

Phone

(618) 234-7181

Fax

(618) 234-9811

NPI assigned

Aug 31, 2006

Last updated

Dec 8, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stephen Clement, R.PHNPI 1477667848

Title

President

Phone

(618) 234-7181

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• COPPER BEND PHARMACY INC Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stephen J Clement, R.PH.

  • Pharmacist
  • Belleville, IL
  • NPI 1477667848
  NPD (past) Authorized official
• Nicole Marie Oberto, PHARM.D.

  • Pharmacist
  • Belleville, IL
  • NPI 1952406068
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481155200000",
    "number": "1902918840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 FRANK SCOTT PKWY W",
            "address_2": "STE 920-B",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622238509",
            "telephone_number": "618-234-7181",
            "fax_number": "618-234-9811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 FRANK SCOTT PKWY W",
            "address_2": "STE 920-B",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622235000",
            "telephone_number": "618-234-7181",
            "fax_number": "618-234-9811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COPPER BEND PHARMACY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2016-12-08",
        "status": "A",
        "authorized_official_last_name": "CLEMENT",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-234-7181",
        "authorized_official_credential": "R.PH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054008430",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2018496",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COPPER BEND PHARMACY INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Julianna M Compton, CRNA
• Noah Conard, PHARM. D.
• Confident Communication LLC
• Paige Conner
• Consistent Medical Transportation
• Leah D Corbitt, CRNA
• Kathy Jo Corn, MA, LCPC
• Victoria Corporon
• Chasity Cosby
• Donald Clay Courtial, PT

• Community/Retail Pharmacy in Belleville, IL
• Providers in Belleville, IL by specialty
• Community/Retail Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2016; 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.