MEDICARE: THE CORNER DRUG AND WELLNESS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1518820430
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE CORNER DRUG AND WELLNESS, LLC

Provider Business Mailing Address
First Line	:	350 W SHORE DR
Second Line	:
City	:	ALEXANDRIA
State	:	LA
Zip	:	71303-7006
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4116 JACKSON ST
Second Line	:
City	:	ALEXANDRIA
State	:	LA
Zip	:	71303-2752
Country	:	US
Telephone Number	:	318-709-8262
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	AUSTIN PEAVY
Credential	:	PHARMD
Telephone Number	:	318-709-8262

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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