Provider Demographics
NPI:1548872336
Name:CORNER DRUGS INC
Entity type:Organization
Organization Name:CORNER DRUGS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:706-695-0444
Mailing Address - Street 1:430 N 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30705-2540
Mailing Address - Country:US
Mailing Address - Phone:706-695-0444
Mailing Address - Fax:855-710-7228
Practice Address - Street 1:430 N 3RD AVE
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:GA
Practice Address - Zip Code:30705-2540
Practice Address - Country:US
Practice Address - Phone:706-695-0444
Practice Address - Fax:855-710-7228
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CORNER DRUGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-08-21
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAPHRE002779OtherPHARMACY