Healthcare Provider Details

I. General information

NPI: 1669754255
Provider Name (Legal Business Name): INGLES MARKETS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2011
Last Update Date: 08/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

199 HABERSHAM COUNTY SHOPPING CTR
CORNELIA GA
30531-3412
US

IV. Provider business mailing address

PO BOX 603941
CHARLOTTE NC
28260-3941
US

V. Phone/Fax

Practice location:
  • Phone: 706-778-8099
  • Fax: 706-778-8100
Mailing address:
  • Phone: 828-669-2941
  • Fax: 828-669-3685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHRE009778
License Number StateGA

VIII. Authorized Official

Name: MR. STEPHEN V CUCCHI
Title or Position: VP OF PHARMACY
Credential: RPH
Phone: 828-669-2941