=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568509339
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BOONE DRUGS INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/31/2007
-----------------------------------------------------
Last Update Date | 03/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 202 W KING ST
-----------------------------------------------------
City | BOONE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28607-3516
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-264-8929
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 345 DEERFIELD RD
-----------------------------------------------------
City | BOONE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28607-5009
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-355-3365
-----------------------------------------------------
Fax | 828-264-0543
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VICE PRESIDENT
-----------------------------------------------------
Name | SPENCER W HODGES
-----------------------------------------------------
Credential | PHARMD
-----------------------------------------------------
Telephone | 828-264-3055
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 333600000X
-----------------------------------------------------
Taxonomy Name | Pharmacy
-----------------------------------------------------
License Number | 333600000X
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------