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Organization

TCP1, LLC

Active
Other names
THE CORNER PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
PHIL WORRELL RPH (DIR OF PHRM)
(314) 567-7994
Entity
Organization

Contact information

Practice address
12266 DEPAUL DRIVE, SUITE 105, BRIDGETON, MO 63044
(314) 344-7567
(314) 344-7179
Mailing address
727 N NEW BALLAS RD, CREVE COEUR, MO 63141-6715
(314) 567-7994
(314) 567-0323

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
2005000826
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2635867
NCPDP PROVIDER IDENTIFICATION NUMBER
05
606172302
MO
Enumeration date
01/17/2007
Last updated
06/18/2009
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