NPI Database
Lookup NPI Numbers from the NPI Registry

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
 Website: http://www.yourcornerrx.com
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Compounding Pharmacy

3336C0004X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for YOUR CORNER DRUGSTORE

NPI Number 1629433529
LBN Legal business name YOUR CORNER DRUG STORE LLC
DBA Doing business as YOUR CORNER DRUGSTORE
Authorized official MATTHEW FRAZIER - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 12/18/2015
Last updated 04/19/2017 - About 9 years ago
Identifiers
GA License # PHRE010205
GA Medicaid 003173406A
Other 2156014 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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