YOUR CORNER DRUG STORE LLC (NPI# 1629433529) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629433529 |
| Entity Type | Organization |
| Organization Name | YOUR CORNER DRUG STORE LLC |
| Other Organization Name | YOUR CORNER DRUGSTORE |
| Practice Address |
4260 Log Cabin Dr Ste C Macon GA 31204-4852 |
| Mailing Address |
104 Lorraine Forest Ct Macon GA 31210-5316 |
| Practice Telephone | 4782548484 |
| Practice Fax Number | 4782548020 |
| Mailing Telephone | 4789941189 |
| Enumeration Date | 2015-12-18 |
| Last Update Date | 2017-04-19 |
| Authorized Official Name | MATTHEW FRAZIER (OWNER) |
| Authorized Official Telephone | 4782548484 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHRE010205 | GA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003173406A | 05 | |
| PK | 2156014 | 01 |
| Other Name | Type Code |
|---|---|
| Your Corner Drugstore | Doing Business As Name - Organization |
| Street Address |
4260 LOG CABIN DR STE C |
| City | MACON |
| State | GA |
| Zip Code | 31204-4852 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942775085 | Amy Lynn Miller | Counselor | 890 Northwoods Plaza/burrus Road, Macon, GA 31204 | 2018-10-04 |
| 1275056566 | Kenyada Moss | Counselor | 762 Thurmond Dr., Macon, GA 31204 | 2017-07-19 |
| 1508303876 | Amber Foster | Counselor | 890 Northwoods Plaza, Macon, GA 31204 | 2017-01-25 |
| 1952757585 | Sarah Vanselous Spencer | Speech-Language Pathologist | 2720 Sheraton Dr # D-140, Macon, GA 31204 | 2016-05-12 |
| 1952706343 | Matthew Wayne Frazier | Pharmacist | 4260 Log Cabin Dr, Macon, GA 31204 | 2014-10-28 |
| 1215338587 | Sharon Yvette Flewellen | Licensed Practical Nurse | 1876 Moore Street, Macon, GA 31204 | 2014-09-05 |
| 1336565647 | Accel Wellness Center, LLC | Specialist | 3083 Vineville Avenue, Macon, GA 31204 | 2014-03-11 |
| 1821439811 | Irene Gung Ho | Physician Assistant | 3203 Vineville Ave Ste A, Macon, GA 31204 | 2013-07-08 |
| 1518125657 | Jennifer Burns | Marriage & Family Therapist | 116 Pierce Avenue, Macon, GA 31204 | 2008-05-27 |
| 1255599346 | Methodist Home of The South Georgia Conference, Inc. | Voluntary or Charitable | 304 Pierce Avenue, Macon, GA 31204 | 2008-05-27 |
| Find all providers in zip 31204 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | 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. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194348011 | First Choice Primary Care, Inc | Pharmacy | 400 Poplar St Rm 125, Macon, GA 31201-3336 | 2020-05-27 |
| 1417508789 | Elite Apothecary Services, LLC | Pharmacy | 5300 Bowman Park Rm A, Macon, GA 31210-6583 | 2019-09-26 |
| 1700360831 | Houston County Health Department | Pharmacy | 158 Emery Hwy, Macon, GA 31217-3656 | 2018-09-25 |
| 1134616113 | Noxubee General Critical Access Hospital | Pharmacy | 34 Hospital Road, Macon, MS 39341 | 2018-04-16 |
| 1881133064 | A & A Pharmacy LLC | Pharmacy | 4683 Log Cabin Dr, Macon, GA 31204-6317 | 2017-02-21 |
| 1689810095 | Southern Family Markets LLC | Pharmacy | 1425 Rocky Creek Rd, Macon, GA 31206-3575 | 2009-01-07 |
| 1356595417 | Express Rx Pharmacy, LLC. | Pharmacy | 743 Shurling Dr, Macon, GA 31211-1947 | 2008-11-15 |
| 1306980008 | Consultants' Pharmacy | Pharmacy | 655 North Ave, Ste B, Macon, GA 31211 | 2007-02-16 |
| 1710020870 | Smith Management Services LLC | Pharmacy | 655 North Ave Ste A, Macon, GA 31211 | 2007-02-15 |
| 1982707725 | Georgia Cvs Pharmacy LLC | Pharmacy | 1271 Gray Hwy, Macon, GA 31211-1919 | 2006-09-07 |
| Find all providers in MACON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.