Organization
BOONES CREEK PHARMACY, INC.
Active
Organization
BOONES CREEK PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CADEN WALKER COX (PIC)
(423) 283-0911
Entity
Organization
Contact information
Practice address
4729 N ROAN ST STE 2, JOHNSON CITY, TN 37615-3886
(423) 283-0911
(423) 283-0990
Mailing address
4729 N ROAN ST STE 2, JOHNSON CITY, TN 37615-3733
(423) 283-0911
(423) 283-0990
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q036582
—
TN
Enumeration date
09/18/2020
Last updated
04/28/2026
Update your record
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