PPG STORE 2 LLC (NPI# 1447619572) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447619572 |
| Entity Type | Organization |
| Organization Name | PPG STORE 2 LLC |
| Other Organization Name | CORNERSTONE PHARMACY GENTRY |
| Practice Address |
560 Gentry Blvd Gentry AR 72734-8576 |
| Mailing Address |
Po Box 8070 Fayetteville AR 72703-0001 |
| Practice Telephone | 4795256200 |
| Practice Fax Number | 4795256168 |
| Mailing Telephone | 4795256200 |
| Mailing Fax Number | 8888610863 |
| Enumeration Date | 2016-02-17 |
| Last Update Date | 2016-03-31 |
| Authorized Official Name | ZACH HOLDERFIELD (OWNER, PIC, AO) |
| Authorized Official Telephone | 8708140605 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
AR20833 | AR | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2158041 | 01 |
| Other Name | Type Code |
|---|---|
| Cornerstone Pharmacy Gentry | Doing Business As Name - Organization |
| Street Address |
560 GENTRY BLVD |
| City | GENTRY |
| State | AR |
| Zip Code | 72734-8576 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831314574 | Scott David Stubbs | Dentist | 304 East Main, Gentry, AR 72734 | 2007-04-16 |
| 1760534226 | Alan L Lamb | Dentist | 304 E Main, Gentry, AR 72734 | 2007-01-17 |
| 1124182142 | Ford Dental Care | Dentist | 125 N Rust Ave, Gentry, AR 72734 | 2006-12-21 |
| 1225080286 | Robert H Weaver | Family Medicine | 643 E Third St, Gentry, AR 72734 | 2006-05-17 |
| 1487646022 | Jerry Derek Ford | Dentist | 125 North Rust Ave, Gentry, AR 72734 | 2005-08-19 |
| 1033356472 | Gentry Family Dentistry Pllc | Dentist | 304 E Main, Gentry, AR 72734 | 2009-01-07 |
| 1609488758 | Kaylin Gene Cripps | Occupational Therapist | 302 W 2nd St, Gentry, AR 72734-5502 | 2020-08-20 |
| 1255410999 | Smith Drug Pllc | Durable Medical Equipment & Medical Supplies | 695 E 3rd St, Gentry, AR 72734-8258 | 2006-11-03 |
| 1861482739 | Catherine Elaine Casey | Nurse Practitioner | 643 E 3rd St, Gentry, AR 72734-8258 | 2005-10-24 |
| 1003388570 | Emily Smith | Pharmacist | 695 E 3rd St, Gentry, AR 72734-8258 | 2018-12-21 |
| Find all providers in zip 72734 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609084565 | Smith Drug | Pharmacy | 695 East Third Street, Gentry, AR 72737-0629 | 2007-05-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356942320 | Freda Cunningham | Pharmacy | 2100 Hwy 77, Marion, AR 72364 | 2020-11-05 |
| 1457978157 | Sc Pharmacy Group Opco LLC | Pharmacy | 1800 Riverfront Dr Ste 100, Little Rock, AR 72202-1882 | 2020-06-29 |
| 1790306124 | Jbr Enterprises Inc | Pharmacy | 600 Hwy 365, Mayflower, AR 72106 | 2020-04-27 |
| 1215557905 | Medman23, Inc | Pharmacy | 3201 Springhill Dr Ste 110, North Little Rock, AR 72117-2910 | 2020-04-22 |
| 1336768985 | Harps Food Stores, Inc | Pharmacy | 611 Highway 62 65 N, Harrison, AR 72601-2208 | 2020-04-14 |
| 1598393605 | Highlands Oncology Group Pa | Pharmacy | 3901 Parkway Circle, Springdale, AR 72762 | 2020-04-01 |
| 1326674870 | Caraway Drug L.l.c | Pharmacy | 106 W. State Street, Caraway, AR 72419 | 2020-03-17 |
| 1104461532 | Pruett's Food, Inc. | Pharmacy | 101 W. Main, Lockesburg, AR 71846 | 2019-11-08 |
| 1760025274 | Holiday Island Pharmacy, LLC | Pharmacy | 2 Forest Park Dr Ste A, Holiday Island, AR 72631-9229 | 2019-10-28 |
| 1730722463 | Beebe Family Pharmacy, LLC | Pharmacy | 1701 W Dewitt Henry Dr, Beebe, AR 72012-2024 | 2019-10-25 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.