Provider Demographics
NPI:1457395774
Name:AVEVE INC
Entity Type:Organization
Organization Name:AVEVE INC
Other - Org Name:FOOTHILLS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-894-6112
Mailing Address - Street 1:80 SHUFORD RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NC
Mailing Address - Zip Code:28722-7406
Mailing Address - Country:US
Mailing Address - Phone:828-894-6112
Mailing Address - Fax:828-894-6115
Practice Address - Street 1:80 SHUFORD RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NC
Practice Address - Zip Code:28722-7406
Practice Address - Country:US
Practice Address - Phone:828-894-6112
Practice Address - Fax:828-894-6115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-16
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NC74723336C0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0755082Medicaid
2072450OtherPK
SC7N7472Medicaid
1295720001Medicare NSC
P00171182Medicare PIN
SC7N7472Medicaid
2801113Medicare PIN
NCP00171182Medicare PIN