Provider Demographics
NPI:1396100897
Name:POWERS, JOHN AUSTIN (RPH)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:AUSTIN
Last Name:POWERS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 IVY RD
Mailing Address - Street 2:
Mailing Address - City:MILLS RIVER
Mailing Address - State:NC
Mailing Address - Zip Code:28759-2605
Mailing Address - Country:US
Mailing Address - Phone:828-808-7972
Mailing Address - Fax:
Practice Address - Street 1:2913 US 70 HWY
Practice Address - Street 2:
Practice Address - City:BLACK MOUNTAIN
Practice Address - State:NC
Practice Address - Zip Code:28711-9103
Practice Address - Country:US
Practice Address - Phone:828-808-7972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-28
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20039183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist