Cornerstone Pharmacy LLC
Organization Active NPI Community/Retail Pharmacy · Appalachia, VA
NPI 1992942841 · NPPES record last updated Dec 17, 2009
Key facts
- NPI
- 1992942841
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- Legal business name
- CORNERSTONE PHARMACY LLC
- Practice address
- 205 Kilbourne Avenue
Appalachia, VA 24216 - Phone
- (276) 565-3434
- NPI assigned
- Jan 14, 2009
- Organization subpart
- No
Authorized official
- Name
- Dr. Leonard Dwight Jessee, PHARM.D.
- Title
- Owner/Pharmacist
- Phone
- (276) 565-3434
Practitioners 1
-
Leonard Dwight Jessee, PHARM.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 49D2254513 | Cornerstone Pharmacy | Certificate of waiver | Mar 3, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111227000436 | VA | Part B Supplier - Mass Immunization (Roster Biller Only) | 8022217017 | Practice locations: Appalachia, VA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Community/Retail Pharmacy | 3336C0003X | Yes |
Addresses
Primary practice location
205 Kilbourne Avenue
Appalachia, VA 24216
Mailing address
PO Box 469
Appalachia, VA 24216-0469
Phone (276) 565-3434
Other names
- Cornerstone Pharmacy
Other providers in Appalachia, VA
- Appalachia Medical Clinic, PC
- Appalachia Pharmacy Inc
- Appalachia Volunteer Fire Department
- Family Preservation Services, Inc
- Kyle Ashton Green
- Leonard Dwight Jessee
- Lisa Frankie Muncy
- David Roberts
All providers in Appalachia, VA · Community/Retail Pharmacy in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 17, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.