Corner Prescription Shoppe Inc
Organization Active NPI Community/Retail Pharmacy · Williamsburg, KY
NPI 1194942292 · NPPES record last updated Jan 5, 2016
Key facts
- NPI
- 1194942292
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- P01565 (KY)
- Legal business name
- CORNER PRESCRIPTION SHOPPE INC
- Practice address
- 401 Sycamore St
Williamsburg, KY 40769-1136 - Phone
- (606) 549-0884
- Fax
- (606) 539-0860
- NPI assigned
- Apr 19, 2007
- Organization subpart
- No
Authorized official
- Name
- Michael Bordes, BACHELOR OF SCI
- Title
- Pres
- Phone
- (606) 549-0884
Practitioners 1
-
Rick Loudermelt, RPH, DPH, RD, LD
National Provider Directory
Locations
401 Sycamore St
Williamsburg, KY 40769
Phone (606) 549-0884
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | P01565 | KY | Yes |
Addresses
Primary practice location
401 Sycamore St
Williamsburg, KY 40769-1136
Mailing address
401 Sycamore St
Williamsburg, KY 40769-1136
Phone (606) 549-0884
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2030349 | Other | PK | |
| 54018171 | Medicaid | KY | |
| 90151184 | Medicaid | KY |
Other names
- CORNER PRESCRIPTION SHOPPE INC
Other providers in Williamsburg, KY
- Sarah Patricia Cloud
- Jacey Cooper
- Robert Wayne Cooper
- Corbin Cardiology & Internal Medicine, Inc.
- Ila Corder
- Michael C Culver
- Cumberland Family Medical Center, Inc.
- Cumberland Foot and Ankle Center
- Cumberland Mountain Behavioral Health
- Cumberland Mountain Behavioral Health
All providers in Williamsburg, KY · Community/Retail Pharmacy in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 5, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.