Healthcare Provider Details

I. General information

NPI: 1912912866
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: 08/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 W JACKSON BLVD
JONESBOROUGH TN
37659-5294
US

IV. Provider business mailing address

PO BOX 603941
CHARLOTTE NC
28260-3941
US

V. Phone/Fax

Practice location:
  • Phone: 423-753-9730
  • Fax: 423-753-4326
Mailing address:
  • Phone: 828-669-2941
  • Fax: 828-669-3685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number4001
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

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