Organization
MOUNTAIN APOTHECARY, INC
Active
Other names
BANNER ELK PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
BILLY JOEL KING PHARMD (PHARMACY MANAGER/OWNER)
(828) 898-4271
Entity
Organization
Contact information
Practice address
110 PARK AVE, BANNER ELK, NC 28604-6604
(828) 898-4271
(828) 898-6761
Mailing address
PO BOX 247, BANNER ELK, NC 28604-0247
(828) 898-4271
(828) 898-6761
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
08150
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0065136
—
NC
01
—
2065009
PK
—
05
—
3403728
—
TN
Enumeration date
06/11/2006
Last updated
08/15/2022
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