Provider Demographics
NPI:1609403716
Name:CORINTH COMMUNITY PHARMACY, LLC.
Entity Type:Organization
Organization Name:CORINTH COMMUNITY PHARMACY, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:940-487-7455
Mailing Address - Street 1:3001 F.M. 2181
Mailing Address - Street 2:SUITE 450
Mailing Address - City:CORINTH
Mailing Address - State:TX
Mailing Address - Zip Code:76210
Mailing Address - Country:US
Mailing Address - Phone:940-487-7455
Mailing Address - Fax:940-279-1605
Practice Address - Street 1:3001 F.M. 2181
Practice Address - Street 2:SUITE 450
Practice Address - City:CORINTH
Practice Address - State:TX
Practice Address - Zip Code:76210
Practice Address - Country:US
Practice Address - Phone:940-487-7455
Practice Address - Fax:940-279-1605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-26
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX33200OtherTEXAS STATE BOARD OF PHARMACY