Mountain States Pharmacy At Boones Creek
LBN: Wilson Pharmacy Inc
Mountain States Pharmacy At Boones Creek is an health care organization with primary practice located at 2685 Boones Creek Rd Ste 105, Johnson City TN 37615-4722. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Wilson Pharmacy Inc can be contacted via phone (423) 282-6337, or through Austin, Lisa via phone (423) 431-1941.
Contact Information
Primary practice address
2685 Boones Creek Rd Ste 105
Johnson City TN 37615-4722
Phone: (423) 282-6337
Fax: (423) 282-5264
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 4307 | Tennessee |
Profile Details
| NPI number | 1467567404 |
|---|---|
| LBN Legal business name | Wilson Pharmacy Inc |
| DBA Doing business as | Mountain States Pharmacy At Boones Creek |
| Authorized official | Austin, Lisa |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 20th, 2006 |
| Last updated | Nov 17th, 2017 - about 7 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467567404 | NPPES |
| Other | 2095039 | PK | |
| MEDICAID | 9440037 | PK |
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