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General NPI Number Information
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NPI Number | 1972598431
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Entity Type | Organization
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Legal Business Name | CORONA DRUG,INC.
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Dates
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Enumeration Date | 09/12/2005
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 221 EAST THIRD STREET
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City | CORONA
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State | CA
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Zip | 92879
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Country | US
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Telephone | 951-735-4600
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Fax | 951-284-4701
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Provider Business Mailing Address
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Address Line | 221 EAST THIRD STREET
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City | CORONA
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State | CA
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Zip | 92879
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Country | US
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Telephone | 951-735-4600
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Fax | 951-284-4701
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Authorized Official
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Title or Position | CFO
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Name | MR. OLEG PILLER
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Credential |
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Telephone | 951-735-4600
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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 | PHY45243
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License Number State | CA
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