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Organization
CORNER DRUG CO INC
Active
Organization
CORNER DRUG CO INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVD DEW DPH (OWNER)
(865) 426-2851
Entity
Organization
Contact information
Practice address
414 MAIN ST, LAKE CITY, TN 37769
(865) 426-2851
(865) 426-9446
Mailing address
P0 BOX 455, LAKE CITY, TN 37769
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
TN595
TN
3336C0003X
Community/Retail Pharmacy
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—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4408161
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/10/2006
Last updated
08/14/2012
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