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General NPI Number Information
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NPI Number | 1699254839
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Entity Type | Organization
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Legal Business Name | CORNER PHARMACY INCORPORATED
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Dates
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Enumeration Date | 08/08/2018
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Last Update Date | 08/17/2018
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Provider Practice Location Address
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Address Line | 112 N 5TH AVE STE 101
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City | PHOENIX
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State | AZ
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Zip | 85003
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Country | US
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Telephone | 602-258-0128
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Fax | 602-258-0248
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Provider Business Mailing Address
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Address Line | 112 N 5TH AVE STE 101
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City | PHOENIX
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State | AZ
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Zip | 85003-1633
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Country | US
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Telephone | 602-258-0128
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Fax | 602-258-0248
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MR. RUBEN GARIBYAN
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Credential |
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Telephone | 602-258-0128
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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 | AZ
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