Boones Creek Pharmacy, Inc.

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

BOONES CREEK PHARMACY, INC.

Practice address

4729 N Roan St Ste 2
Johnson City, TN 37615-3886

Phone

(423) 283-0911

Fax

(423) 283-0990

NPI assigned

Sep 18, 2020

Last updated

Apr 28, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Caden Walker CoxNPI 1821684051

Title

Pic

Phone

(423) 283-0911

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Boones Creek Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Boones Creek Pharmacy, Inc.

  dba Boones Creek Pharmacy

  • Community/Retail Pharmacy
  • Johnson City, TN
  • NPI 1073940334
  NPD tax ID

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.

• Caden Walker Cox, PHARMD

  • Pharmacist
  • Johnson City, TN
  • NPI 1821684051
  NPD Authorized official
• Mark Guimond, PHARMD

  • Pharmacist
  • Johnson City, TN
  • NPI 1649623638
  NPD

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

{
    "created_epoch": "1600387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777334400000",
    "number": "1770199432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4729 N ROAN ST STE 2",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376153733",
            "telephone_number": "423-283-0911",
            "fax_number": "423-283-0990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4729 N ROAN ST STE 2",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376153886",
            "telephone_number": "423-283-0911",
            "fax_number": "423-283-0990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOONES CREEK PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-18",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A",
        "authorized_official_last_name": "COX",
        "authorized_official_first_name": "CADEN",
        "authorized_official_middle_name": "WALKER",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "423-283-0911"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q036582",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eric Bookout, MD
• Amanda F Boone, LPN
• Boones Creek Dentistry
• Boones Creek Medical PLLC
• Boones Creek Pharmacy, Inc. (Boones Creek Pharmacy)
• Sarah Elizabeth Boop, RN, MPH
• Teddy Wayne Booth II, LCSW
• Thomas R. Borthwick, M.D.
• Britny King Boswell Hall, FNP
• Bill N Boswell, M.D.

• Long Term Care Pharmacy in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Long Term Care Pharmacy in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.