Healthcare Provider Details

I. General information

NPI: 1760477079
Provider Name (Legal Business Name): CORNER DRUG CO.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2005
Last Update Date: 09/02/2025
Certification Date: 07/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 MAIN ST
WOODLAND CA
95695-3405
US

IV. Provider business mailing address

PO BOX 1812
WOODLAND CA
95776-1812
US

V. Phone/Fax

Practice location:
  • Phone: 530-662-2813
  • Fax: 530-662-1031
Mailing address:
  • Phone: 530-662-2813
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SARA SHELLEY
Title or Position: CEO
Credential: PHARMD
Phone: 530-662-2813