Healthcare Provider Details
I. General information
NPI: 1194730044
Provider Name (Legal Business Name): INGLES MARKETS INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/29/2006
Last Update Date: 02/08/2022
Certification Date: 02/08/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
864 OLD GREENVILLE HWY
CLEMSON SC
29631-1228
US
IV. Provider business mailing address
PO BOX 603941
CHARLOTTE NC
28260-3941
US
V. Phone/Fax
- Phone: 864-654-3094
- Fax: 864-654-3109
- Phone: 828-669-2941
- Fax: 828-669-3685
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 50008590 |
| License Number State | SC |
VIII. Authorized Official
Name: MR.
STEPHEN
V
CUCCHI
Title or Position: VP OF PHARMACY
Credential: RPH
Phone: 828-669-2941