Provider Demographics
NPI:1912086182
Name:BOONE DRUGS INC
Entity type:Organization
Organization Name:BOONE DRUGS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SPENCER
Authorized Official - Middle Name:W
Authorized Official - Last Name:HODGES
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:828-264-3055
Mailing Address - Street 1:345 DEERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-5009
Mailing Address - Country:US
Mailing Address - Phone:828-355-3365
Mailing Address - Fax:
Practice Address - Street 1:1641 S SHADY ST
Practice Address - Street 2:
Practice Address - City:MOUNTAIN CITY
Practice Address - State:TN
Practice Address - Zip Code:37683-2015
Practice Address - Country:US
Practice Address - Phone:828-355-3365
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN332BP3500X332BP3500X
TN332BX2000X332BX2000X
TN3020333600000X
332BC3200X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No333600000XSuppliersPharmacy
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0146320002Medicare ID - Type Unspecified