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General NPI Number Information
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NPI Number | 1518820430
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Entity Type | Organization
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Legal Business Name | THE CORNER DRUG AND WELLNESS, LLC
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Dates
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Enumeration Date | 12/08/2025
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 4116 JACKSON ST
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City | ALEXANDRIA
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State | LA
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Zip | 71303-2752
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Country | US
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Telephone | 318-709-8262
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Fax |
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Provider Business Mailing Address
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Address Line | 350 W SHORE DR
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City | ALEXANDRIA
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State | LA
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Zip | 71303-7006
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AUSTIN PEAVY
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Credential | PHARMD
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Telephone | 318-709-8262
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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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