Healthcare Provider Details

I. General information

NPI: 1427860881
Provider Name (Legal Business Name): CORNER DRUG STORE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2025
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 W SPRING ST STE 6
DODGEVILLE WI
53533-1300
US

IV. Provider business mailing address

333 LOWVILLE RD
RIO WI
53960-9437
US

V. Phone/Fax

Practice location:
  • Phone: 608-935-3661
  • Fax: 608-935-2661
Mailing address:
  • Phone: 920-992-6800
  • Fax: 920-614-6100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DANIEL STRAUSE
Title or Position: OWNER
Credential:
Phone: 920-992-6800