Provider Demographics
NPI:1326086075
Name:PROCOR
Entity Type:Organization
Organization Name:PROCOR
Other - Org Name:HOSPITAL HILL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:LEONARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-586-7000
Mailing Address - Street 1:470 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:BRYSON CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28713-7752
Mailing Address - Country:US
Mailing Address - Phone:828-488-4272
Mailing Address - Fax:828-488-4264
Practice Address - Street 1:470 CENTER ST
Practice Address - Street 2:
Practice Address - City:BRYSON CITY
Practice Address - State:NC
Practice Address - Zip Code:28713-7752
Practice Address - Country:US
Practice Address - Phone:828-488-4272
Practice Address - Fax:828-488-4264
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC07558183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0875070Medicaid
NC3437820OtherNAPB (NCPDP) #
NC3437820OtherNAPB (NCPDP) #