CORNER DRUG STORE, INC (NPI# 1992751143) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992751143 |
| Entity Type | Organization |
| Organization Name | CORNER DRUG STORE, INC |
| Other Organization Name | CORNER DRUG STORE |
| Practice Address |
316 W Spring St Ste 6 Dodgeville WI 53533-1300 |
| Mailing Address |
333 Lowville Rd Rio WI 53960-9437 |
| Practice Telephone | 6089353661 |
| Practice Fax Number | 6089352661 |
| Mailing Telephone | 9209926800 |
| Mailing Fax Number | 9209926801 |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2019-11-05 |
| Authorized Official Name | MR. DANIEL STRAUSE (CEO) |
| Authorized Official Telephone | 9209926800 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
Suppliers | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | 5538-042 | WI | Suppliers |
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
5538-042 | WI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 33119600 | 05 | |
| WI | NCPDP | 5105691 | 01 |
| Other Name | Type Code |
|---|---|
| Corner Drug Hometown Pharmacy | Doing Business As Name - Organization |
| Corner Drug Store | Doing Business As Name - Organization |
| Street Address |
316 W SPRING ST STE 6 |
| City | DODGEVILLE |
| State | WI |
| Zip Code | 53533-1300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437361706 | Jeffrey Scott Wilton | Dentist | 103 E Fountain St, Dodgeville, WI 53533 | 2007-05-07 |
| 1134253420 | Southwest Dental Associates, S.c. | Clinic/Center | 1208 Joseph Street, Dodgeville, WI 53533 | 2007-03-16 |
| 1750420170 | Michael Charles Fisher | Dentist | 1208 North Joseph Street, Dodgeville, WI 53533 | 2007-02-05 |
| 1225191901 | Wal-mart Stores East, Lp | Technician/Technologist | 601 Leffler St., Dodgeville, WI 53533 | 2006-12-18 |
| 1164458626 | Laura Jean Gjestson | Counselor | 829 S Iowa St, Dodgeville, WI 53533 | 2006-06-24 |
| 1235602517 | Lauren Rae Bakken Olinger | Respiratory Therapist, Registered | 800 Compassion Way, Cardio Pulmonary, Dodgeville, WI 53533 | 2019-01-09 |
| 1124400627 | Katherine J Ponsler | Physician Assistant | 833 S Iowa St, Ste 102, Dodgeville, WI 53533 | 2015-06-22 |
| 1326458803 | Jenifer Lynn Dankyi | Obstetrics & Gynecology | 800 Compassion Way, Dodgeville, WI 53533 | 2014-05-06 |
| 1063430593 | Young I Kim | Surgery | 833 S Iowa St, Suite 106, Dodgeville, WI 53533 | 2006-07-17 |
| 1417226325 | Jaimee Jordan | Dietitian, Registered | 800 Compassion Way, Dodgeville, WI 53533-0800 | 2011-12-21 |
| Find all providers in zip 53533 | ||||
| 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 |
|---|---|---|---|---|
| 1942816939 | The Duluth Clinic, Ltd. | Pharmacy | 204 Belknap St, Ste 100, Superior, WI 54880-2964 | 2020-09-16 |
| 1902417207 | Ipack Pharmacy LLC | Pharmacy | 17000 W North Ave Ste 108w, Brookfield, WI 53005-4423 | 2020-08-11 |
| 1851939037 | Ascension Wisconsin Pharmacy, Inc | Pharmacy | 10180 Washington Ave Ste 102, Mount Pleasant, WI 53177-1604 | 2019-12-18 |
| 1558906354 | Life Change Rx 4 LLC | Pharmacy | 6300 N 76th St Ste 246, Milwaukee, WI 53218-1208 | 2019-11-15 |
| 1285278978 | Life Change Rx 3 LLC | Pharmacy | 7115 W Capitol Dr, Milwaukee, WI 53216-2051 | 2019-11-05 |
| 1295377703 | Hayat Pharmacy 21 LLC. | Pharmacy | 2333 Northwestern Ave Ste 120, Racine, WI 53404-2520 | 2019-10-16 |
| 1487296737 | Xperience Pharmacy LLC | Pharmacy | 5715 W Appleton Ave, Milwaukee, WI 53210-2250 | 2019-10-08 |
| 1962053421 | Hayat Pharmacy 19 LLC | Pharmacy | 805 W. Layton Ave. Suite A, Milwaukee, WI 53221 | 2019-09-26 |
| 1275182925 | Walgreen Co | Pharmacy | 2265 N Mayfair Rd, Wauwatosa, WI 53226-2207 | 2019-09-05 |
| 1982257200 | Hayat Pharmacy 16 LLC | Pharmacy | 603 N 36th St, Milwaukee, WI 53208-3826 | 2019-07-17 |
| Find all providers with the same taxonomy | ||||
| City | DODGEVILLE |
| Zip Code | 53533 |
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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.