Healthcare Provider Details

I. General information

NPI: 1831304799
Provider Name (Legal Business Name): CORNER HOMECARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 10/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 E WASHINGTON ST
PRINCETON KY
42445-2250
US

IV. Provider business mailing address

108 E WASHINGTON ST
PRINCETON KY
42445-2250
US

V. Phone/Fax

Practice location:
  • Phone: 270-365-3903
  • Fax: 270-365-2024
Mailing address:
  • Phone: 270-365-3903
  • Fax: 270-365-2024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. STEVE K PPOOL
Title or Position: CEO
Credential: RPH
Phone: 270-365-3903