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General NPI Number Information
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NPI Number | 1295018794
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Entity Type | Organization
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Legal Business Name | MISSION HOSPITAL INC
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Dates
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Enumeration Date | 09/21/2011
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Last Update Date | 02/16/2017
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Provider Practice Location Address
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Address Line | 400 RIDGEFIELD CT STE 106
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City | ASHEVILLE
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State | NC
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Zip | 28806-2213
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Country | US
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Telephone | 828-257-7057
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Fax | 828-257-7059
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Provider Business Mailing Address
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Address Line | 400 RIDGEFIELD CT SUITE 106
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City | ASHEVILLE
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State | NC
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Zip | 28806-2213
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Country | US
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Telephone | 828-257-7057
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Fax | 828-257-7059
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Authorized Official
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Title or Position | DIRECTOR-RETAIL PHARMACY
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Name | TIMOTHY GENTILCORE
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Credential | PHARMD
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Telephone | 828-213-0048
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336M0002X
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Taxonomy Name | Mail Order Pharmacy
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License Number | 11072
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License Number State | NC
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