Healthcare Provider Details

I. General information

NPI: 1265461040
Provider Name (Legal Business Name): CORNER DRUG WINCHESTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 11/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 N HIGHLAND ST SUITE B
WINCHESTER KY
40391-2024
US

IV. Provider business mailing address

PO BOX 220
WINCHESTER KY
40392-0220
US

V. Phone/Fax

Practice location:
  • Phone: 859-744-6844
  • Fax: 859-744-2963
Mailing address:
  • Phone: 859-744-6844
  • Fax: 859-744-2963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License NumberP06963
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number90011511
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberP06963
License Number StateKY

VIII. Authorized Official

Name: DR. NANCY HORN BARKER
Title or Position: OWNER/PHARMACIST
Credential:
Phone: 859-744-6844