Organization Active NPI

Corley & McClendon, Inc.

  • Community/Retail Pharmacy
  • Lagrange, GA
National Provider Identifier
1396764213
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHRE007019 Issued in GA
Legal business name
CORLEY & MCCLENDON, INC.
Doing business as
Corley Drugs #4
Practice address
18 New Airport Road
Lagrange, GA 30240
Phone
(706) 884-2517
Fax
(706) 882-3818
NPI assigned
Jul 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Mr. James David Cochran, RPH
Title
Owner/Pharmacist
Phone
(706) 884-2661

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHRE007019 GA Primary

Addresses

Primary practice location

18 New Airport Road
Lagrange, GA 30240

Mailing address

18 New Airport Road
Suite B
Lagrange, GA 30240
Phone (706) 885-9213

Other identifiers 5

IdentifierTypeStateIssuer
00383666AMedicaidGA
PHRE007019OtherGASTATE PHARMACY LICENSE
1133393OtherNCPDP#
000383666AMedicaidGA
1396764213OtherNPI

Other names 1

  • Corley Drugs #4 Doing business as

National Provider Directory

National Provider Directory

Locations

18 New Airport Rd
Lagrange, GA 30240
Phone (706) 884-2517

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1396764213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 NEW AIRPORT ROAD",
            "address_2": "SUITE B",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "30240",
            "telephone_number": "706-885-9213",
            "fax_number": "706-885-9829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 NEW AIRPORT ROAD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "30240",
            "telephone_number": "706-884-2517",
            "fax_number": "706-882-3818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORLEY & MCCLENDON, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "COCHRAN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "706-884-2661",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE007019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00383666A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PHARMACY LICENSE",
            "identifier": "PHRE007019",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP#",
            "identifier": "1133393",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000383666A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1396764213",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corley Drugs #4",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lagrange, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.