Provider Demographics
NPI:1669007092
Name:LUCKIE PRODUCTS AND GOODS
Entity Type:Organization
Organization Name:LUCKIE PRODUCTS AND GOODS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORGANIZER
Authorized Official - Prefix:
Authorized Official - First Name:CARY
Authorized Official - Middle Name:
Authorized Official - Last Name:HITCHCOCK
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:828-407-3710
Mailing Address - Street 1:757 HAYWOOD RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-3132
Mailing Address - Country:US
Mailing Address - Phone:828-407-3710
Mailing Address - Fax:
Practice Address - Street 1:45 W HOLDEN RD
Practice Address - Street 2:
Practice Address - City:BREVARD
Practice Address - State:NC
Practice Address - Zip Code:28712-5527
Practice Address - Country:US
Practice Address - Phone:828-773-8628
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-05
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)