Provider Demographics
NPI:1538201884
Name:THE CORNER DRUG STORE, INC
Entity type:Organization
Organization Name:THE CORNER DRUG STORE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:MORTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM, D
Authorized Official - Phone:205-647-5454
Mailing Address - Street 1:10107 CORNER SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:WARRIOR
Mailing Address - State:AL
Mailing Address - Zip Code:35180-3083
Mailing Address - Country:US
Mailing Address - Phone:205-647-5454
Mailing Address - Fax:205-647-5480
Practice Address - Street 1:10107 CORNER SCHOOL RD
Practice Address - Street 2:
Practice Address - City:WARRIOR
Practice Address - State:AL
Practice Address - Zip Code:35180-3083
Practice Address - Country:US
Practice Address - Phone:205-647-5454
Practice Address - Fax:205-647-5480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL112746183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty