Corner Drug Stores of Knightdale, Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

11853 Issued in NC

Legal business name

CORNER DRUG STORES OF KNIGHTDALE, INC

Practice address

6905 Knightdale Blvd
Suite 102
Knightdale, NC 27545-6505

Phone

(919) 261-6999

Fax

(919) 261-6012

NPI assigned

Mar 4, 2014

Last updated

Mar 4, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Adrian Wyatt Adams, RPH

Title

President

Phone

(919) 261-6999

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1393891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393891200000",
    "number": "1639594369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 N ARENDELL AVE",
            "city": "ZEBULON",
            "state": "NC",
            "postal_code": "275972605",
            "telephone_number": "919-269-9998",
            "fax_number": "919-269-9998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6905 KNIGHTDALE BLVD",
            "address_2": "SUITE 102",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275456505",
            "telephone_number": "919-261-6999",
            "fax_number": "919-261-6012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNER DRUG STORES OF KNIGHTDALE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-04",
        "last_updated": "2014-03-04",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "ADRIAN",
        "authorized_official_middle_name": "WYATT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-261-6999",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "11853",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCBOP",
            "identifier": "11853",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Daniel Ross Conti, DDS
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• Hailey Coston
• Diana Elizabeth Creech
• Corey Lynn Crook
• Annie Crowley, CNP
• Cultural Communal LLC

• Community/Retail Pharmacy in Knightdale, NC
• Providers in Knightdale, NC by specialty
• Community/Retail Pharmacy in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2014; 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.