National Provider Identifier Database

YOUR CORNER DRUGSTORE YOUR CORNER DRUG STORE LLC
Community/Retail Pharmacy

A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.


Contact Information

YOUR CORNER DRUGSTORE
LBN YOUR CORNER DRUG STORE LLC
4260 LOG CABIN DR STE C
MACON, GA31204
Phone: 478-254-8484
Fax: 478-254-8020
Specialty Taxonomy Code
* Community/Retail Pharmacy 3336C0003X
Compounding Pharmacy 3336C0004X
Pharmacy 333600000X

* Indicates primary specialty

NPI Profile & details for YOUR CORNER DRUGSTORE

NPI Number 1629433529
Legal business name
LBN
YOUR CORNER DRUG STORE LLC
Doing business as
DBA
YOUR CORNER DRUGSTORE
Authorized official MATTHEW FRAZIER - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 12/18/2015
Last updated 04/19/2017 - About 9 years ago
Sole proprietor1 Not specified
Identifiers
  • GA License #: PHRE010205
  • GA Medicaid: 003173406A
  • Other: 2156014 PK

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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