Organization
SPRUCE PINE PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF PROFFITT (PRESIDENT)
(828) 765-2281
Entity
Organization
Contact information
Practice address
431 ALTAPASS HWY, SPRUCE PINE, NC 28777-3010
(828) 765-2281
(828) 765-6215
Mailing address
431 ALTAPASS HWY, SPRUCE PINE, NC 28777-3010
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
00668
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0315161
—
NC
05
—
0615161
—
NC
01
—
3411244
OTHER ID NUMBER
—
Enumeration date
03/02/2007
Last updated
10/16/2007
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