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General NPI Number Information
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NPI Number | 1912292210
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Entity Type | Organization
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Legal Business Name | CORNER PHARMACY LLC
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Dates
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Enumeration Date | 06/14/2011
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Last Update Date | 06/13/2013
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Provider Practice Location Address
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Address Line | 1701 ALEXANDRIA DR STE C
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City | LEXINGTON
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State | KY
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Zip | 40504-3149
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Country | US
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Telephone | 859-309-1230
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Fax | 859-309-1330
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Provider Business Mailing Address
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Address Line | 1701 ALEXANDRIA DR SUITE C
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City | LEXINGTON
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State | KY
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Zip | 40504-3149
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Country | US
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Telephone | 859-309-1230
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Fax | 859-335-9668
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Authorized Official
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Title or Position | RPH/OWNER
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Name | KATHERINE CHASE
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Credential |
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Telephone | 859-536-5845
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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 | P07454
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License Number State | KY
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