Boones Creek Pharmacy, Inc.

LBN: Boones Creek Pharmacy, Inc.
Boones Creek Pharmacy, Inc. is an health care organization with primary practice located at 4729 N Roan St Ste 2 , Johnson City TN 37615-3886. The organization recently has only one registered license in Suppliers / Long Term Care Pharmacy, which is considered as the primary health care specialty. Boones Creek Pharmacy, Inc. can be contacted via phone (423) 283-0911, or through Guimond, Mark via phone (423) 283-0911.

Contact Information

Primary practice address
4729 N Roan St Ste 2 Johnson City TN 37615-3886
Phone: (423) 283-0911
Fax: (423) 283-0990
Website:
Map and Directions
Authorized official contact:
Name: Guimond, Mark
Phone: (423) 283-0911

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Long Term Care Pharmacy 3336L0003X

Profile Details

NPI number 1770199432
LBN Legal business name Boones Creek Pharmacy, Inc.
DBA Doing business as
Authorized official Guimond, Mark
Entity Organization
Organization subpart 1 No
Enumeration date Sep 18th, 2020
Last updated Apr 7th, 2023 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770199432 NPPES
Tennessee MEDICAID Q036582

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