Provider Demographics
NPI:1114082534
Name:ASHEVILLE DISCOUNT PHARMACY INC
Entity Type:Organization
Organization Name:ASHEVILLE DISCOUNT PHARMACY INC
Other - Org Name:ASHEVILLE DISCOUNT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HASHIM
Authorized Official - Middle Name:
Authorized Official - Last Name:BADR
Authorized Official - Suffix:
Authorized Official - Credentials:PHRM
Authorized Official - Phone:828-258-8511
Mailing Address - Street 1:76 PATTON AVE
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-3315
Mailing Address - Country:US
Mailing Address - Phone:828-258-8511
Mailing Address - Fax:828-258-8585
Practice Address - Street 1:76 PATTON AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-3315
Practice Address - Country:US
Practice Address - Phone:828-258-8511
Practice Address - Fax:828-258-8585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NC041453336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2068881OtherPK
NC0115956Medicaid
NC0115956Medicaid