Healthcare Provider Details

I. General information

NPI: 1326086075
Provider Name (Legal Business Name): PROCOR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

470 CENTER ST
BRYSON CITY NC
28713-7752
US

IV. Provider business mailing address

470 CENTER ST
BRYSON CITY NC
28713-7752
US

V. Phone/Fax

Practice location:
  • Phone: 828-488-4272
  • Fax: 828-488-4264
Mailing address:
  • Phone: 828-488-4272
  • Fax: 828-488-4264

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number07558
License Number StateNC

VIII. Authorized Official

Name: MR. MARK LEONARD
Title or Position: CEO
Credential:
Phone: 828-586-7000