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General NPI Number Information
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NPI Number | 1467188029
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Entity Type | Organization
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Legal Business Name | THE CORNER PHARMACY AND MARKET
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Dates
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Enumeration Date | 07/26/2022
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 4835A MAIN ST
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City | FLORA
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State | MS
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Zip | 39071-9691
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Country | US
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Telephone | 601-665-2299
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Fax | 601-879-7274
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Provider Business Mailing Address
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Address Line | PO BOX 398
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City | FLORA
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State | MS
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Zip | 39071-0398
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Country | US
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Telephone | 601-665-2299
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Fax | 601-879-7274
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT JORDAN
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Credential | PHARMD
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Telephone | 601-665-2299
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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