NPIMap

Organization Active NPI

Ingles Markets Inc

Doing business as Ingles Pharmacy #457

  • Community/Retail Pharmacy
  • Griffin, GA
National Provider Identifier
1003173030
Registry record updated Feb 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHRE009820 Issued in GA
Legal business name
INGLES MARKETS INC
Doing business as
Ingles Pharmacy #457
Practice address
1735 Zebulon Rd
Griffin, GA 30224-5103
Phone
(770) 228-5815
Fax
(770) 229-8474
NPI assigned
Apr 16, 2012
Last updated
Feb 8, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Stephen V Cucchi, RPH
Title
VP of Pharmacy
Phone
(828) 669-2941

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHRE009820 GA Primary

Addresses

Primary practice location

1735 Zebulon Rd
Griffin, GA 30224-5103

Mailing address

PO Box 603941
Charlotte, NC 28260-3941
Phone (828) 669-2941

Other identifiers 1

IdentifierTypeStateIssuer
003123495AMedicaidGA

Other names 1

  • Ingles Pharmacy #457 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090716000635 GA Part B Supplier - Mass Immunization (Roster Biller Only) 5092867614 35 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Elberton, GA; Ellijay, GA; Flowery Branch, GA; Forsyth, GA; Gray, GA; Griffin, GA; Hartwell, GA; Hiawassee, GA…
O20120907000536 GA DME Supplier - PharmacyDME Supplier - Grocery Store 5092867614 Practice locations: Griffin, GA

Other NPIs on the same Medicare enrollment 33

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 33

National Provider Directory

National Provider Directory

Locations

1735 Zebulon Rd
Griffin, GA 30224
Phone (770) 228-5815

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1334534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644278400000",
    "number": "1003173030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603941",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603941",
            "telephone_number": "828-669-2941",
            "fax_number": "828-669-3685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1735 ZEBULON RD",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302245103",
            "telephone_number": "770-228-5815",
            "fax_number": "770-229-8474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INGLES MARKETS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-16",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A",
        "authorized_official_last_name": "CUCCHI",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "VP OF PHARMACY",
        "authorized_official_telephone_number": "828-669-2941",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHRE009820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003123495A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ingles Pharmacy #457",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ingles Pharmacy #457",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Griffin, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.