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General NPI Number Information
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NPI Number | 1063851657
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Entity Type | Organization
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Legal Business Name | INGLES MARKETS INC
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Dates
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Enumeration Date | 06/18/2013
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Last Update Date | 08/15/2019
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Provider Practice Location Address
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Address Line | 768 W ELK AVE
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City | ELIZABETHTON
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State | TN
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Zip | 37643-2517
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Country | US
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Telephone | 423-542-2002
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Fax | 423-542-2023
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Provider Business Mailing Address
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Address Line | PO BOX 603941
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City | CHARLOTTE
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State | NC
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Zip | 28260-3941
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Country | US
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Telephone | 828-669-2941
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Fax | 828-669-3685
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Authorized Official
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Title or Position | VP OF PHARMACY
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Name | MR. STEPHEN V CUCCHI
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Credential | RPH
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Telephone | 828-669-2941
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 00005184
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License Number State | TN
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