Healthcare Provider Details

I. General information

NPI: 1548872336
Provider Name (Legal Business Name): CORNER DRUGS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2020
Last Update Date: 08/21/2020
Certification Date: 08/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 N 3RD AVE
CHATSWORTH GA
30705-2540
US

IV. Provider business mailing address

430 N 3RD AVE
CHATSWORTH GA
30705-2540
US

V. Phone/Fax

Practice location:
  • Phone: 706-695-0444
  • Fax: 855-710-7228
Mailing address:
  • Phone: 706-695-0444
  • Fax: 855-710-7228

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: DR. JIM RICHARDS
Title or Position: PRESIDENT
Credential: PHARM.D.
Phone: 706-695-0444