Corner Drug Store

Primary specialty

PharmacistTaxonomy code 183500000X

License

00274 Issued in MS

Legal business name

CORNER DRUG STORE

Practice address

1123 Washington St
Vicksburg, MS 39183-2959

Phone

(601) 636-2756

Fax

(601) 638-0071

NPI assigned

Jul 9, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Joseph A Gerache Jr.

Title

Pharmacist

Phone

(601) 636-2756

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tracie Lynn Hale-Smith

  • Pharmacist
  • Vicksburg, MS
  • NPI 1548374424
  NPD (past)

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922031392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1123 WASHINGTON ST",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391832959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1123 WASHINGTON ST",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391832959",
            "telephone_number": "601-636-2756",
            "fax_number": "601-638-0071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNER DRUG STORE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GERACHE",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "601-636-2756",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "00274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00031101",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Wesley Cook, MD
• Kurt David Cooksey, DPT
• Rebecca Cope
• Caitlin Copes, FNP
• Samantha Coppola
• H Cornwall
• Gwendolyn Corrothers Royal, FNP-C
• Counseling Services LLC
• Bryona Courtney
• Cassie Courts

• Pharmacist in Vicksburg, MS
• Providers in Vicksburg, MS by specialty
• Pharmacist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.