Corner Drug Store
NPI #1922031392 in Vicksburg, Mississippi
Provider Information
- NPI Number
- 1922031392
- Entity Type
- Organization
- Organization Name
- Corner Drug Store
- Primary Specialty
- Pharmacist
- Enumeration Date
- Jul 9, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 1123 WASHINGTON ST
- City
- Vicksburg
- State
- Mississippi
- ZIP Code
- 39183-2959
- Phone
- (601) 636-2756
Authorized Official
- Name
- MR. JOSEPH A GERACHE JR.
- Title
- PHARMACIST
- Phone
- (601) 636-2756
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacist |
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