Corner Drug Store Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PP410482L Issued in PA

Legal business name

CORNER DRUG STORE INC

Doing business as

Corner Drug Store Inc

Practice address

142 Walts LN
Johnstown, PA 15906-4123

Phone

(814) 536-5114

NPI assigned

Sep 20, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Robert Bimeal, RPHNPI 1124107503

Title

President

Phone

(814) 243-4937

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• CORNER DRUG STORE INC Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Robert Joseph Bimeal Jr., RPH

  • Pharmacist
  • Johnstown, PA
  • NPI 1124107503
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347926400000",
    "number": "1134226079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 WALTS LN",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159064123",
            "telephone_number": "814-536-5114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 WALTS LN",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159064123",
            "telephone_number": "814-536-5114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNER DRUG STORE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2012-09-18",
        "status": "A",
        "authorized_official_last_name": "BIMEAL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "814-243-4937",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "PA",
            "license": "PP410482L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3918678",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "986505",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CORNER DRUG STORE INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lisa M Cordek, CRNP
• W Theodore Corey, MD
• Michelle Lee Corle, CRNP
• Stacey Lynn Cornelius, LPN
• Jon David Cornell
• David Michael Costlow, PHARMACIST
• Barbara Ann Cowan
• Leigh Ann Craig, CRNA
• Lauren Elizabeth Criswell, PA-C
• Crossroads to Independence, Inc.

• Community/Retail Pharmacy in Johnstown, PA
• Providers in Johnstown, PA by specialty
• Community/Retail Pharmacy in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.