Organization
CORNER PRESCRIPTION SHOPPE INC
Active
Other names
CORNER PRESCRIPTION SHOPPE INC
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL BORDES BACHELOR OF SCI (PRES)
(606) 549-0884
Entity
Organization
Contact information
Practice address
401 SYCAMORE ST, WILLIAMSBURG, KY 40769-1136
(606) 549-0884
(606) 539-0860
Mailing address
401 SYCAMORE ST, WILLIAMSBURG, KY 40769-1136
(606) 549-0884
(606) 539-0860
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
P01565
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2030349
PK
—
05
—
54018171
—
KY
05
—
90151184
—
KY
Enumeration date
04/19/2007
Last updated
01/05/2016
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