Provider Demographics
NPI:1790368298
Name:INGLES MARKETS INC
Entity Type:Organization
Organization Name:INGLES MARKETS INC
Other - Org Name:INGLES PHARMACY #112
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:VINCENT
Authorized Official - Last Name:CUCCHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-669-2941
Mailing Address - Street 1:PO BOX 6676
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28816-6676
Mailing Address - Country:US
Mailing Address - Phone:828-669-2941
Mailing Address - Fax:828-669-3685
Practice Address - Street 1:706 E DIXON BLVD
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28152-6832
Practice Address - Country:US
Practice Address - Phone:704-482-4215
Practice Address - Fax:704-482-4198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-03
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy