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General NPI Number Information
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NPI Number | 1164369674
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Entity Type | Organization
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Legal Business Name | CORNER DRUG STORE, INC
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Dates
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Enumeration Date | 05/01/2026
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Last Update Date | 05/01/2026
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Provider Practice Location Address
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Address Line | 1075 N WISCONSIN AVE
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City | MUSCODA
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State | WI
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Zip | 53573-9116
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Country | US
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Telephone | 608-739-4400
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Fax | 608-739-3490
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Provider Business Mailing Address
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Address Line | 333 LOWVILLE RD
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City | RIO
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State | WI
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Zip | 53960
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Country | US
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Telephone | 920-992-6800
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Fax | 920-614-6100
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Authorized Official
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Title or Position | CONTRACTING MANAGER
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Name | DIANE L DEANS
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Credential |
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Telephone | 920-992-6800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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