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NPI 1770598625

NPI 1770598625 : INGLES MARKETS INC : LOCUST GROVE, GA

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General NPI Number Information
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    NPI Number           |    1770598625
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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     |    07/29/2006
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    Last Update Date     |    08/15/2019
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Provider Practice Location Address
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    Address Line         |    4920 BILL GARDNER PKWY 
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    City                 |    LOCUST GROVE
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    State                |    GA
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    Zip                  |    30248-3647
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    Country              |    US
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    Telephone            |    678-583-8094
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    Fax                  |    678-583-8576
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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       |    PHRE008699
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    License Number State |    GA
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