NPIMap

Organization Active NPI

Ingles Markets Inc

Doing business as Ingles Pharmacy #112

  • Community/Retail Pharmacy
  • Shelby, NC
National Provider Identifier
1790368298
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
INGLES MARKETS INC
Doing business as
Ingles Pharmacy #112
Practice address
706 E Dixon Blvd
Shelby, NC 28152-6832
Phone
(704) 482-4215
Fax
(704) 482-4198
NPI assigned
May 3, 2021
Last updated
Sep 2, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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

Authorized official

Name
Stephen Vincent Cucchi
Title
VP of Pharmacy
Phone
(828) 669-2941

Specialties & licenses 1

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

Addresses

Primary practice location

706 E Dixon Blvd
Shelby, NC 28152-6832

Mailing address

PO Box 6676
Asheville, NC 28816-6676
Phone (828) 669-2941

Other names 1

  • Ingles Pharmacy #112 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090727000367 NC Part B Supplier - Mass Immunization (Roster Biller Only) 5092867614 45 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Franklin, NC; Granite Falls, NC; Hayesville, NC; Hendersonville, NC; Kings Mountain, NC; Lake Lure, NC; Candler, NC; Lincolnton, NC…
O20211014002752 NC DME Supplier - PharmacyDME Supplier - Grocery Store 5092867614 Practice locations: Shelby, NC

Other NPIs on the same Medicare enrollment 45

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

View all 45

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2336434Ingles Markets, Inc (Ingles Pharmacy #112706 E Dixon Blvd, Shelby, NC 28152Certificate of waiverJan 4, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Ingles Pharmacy #112706 E Dixon Blvd, Shelby, NC 28152-6832(704) 482-4215 Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order) Accepts assignmentParticipating since Sep 24, 2024

National Provider Directory

National Provider Directory
Tax ID family
Ingles Pharmacy 41210 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

NPI Registry JSON

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

{
    "created_epoch": "1620000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630540800000",
    "number": "1790368298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6676",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288166676",
            "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": "706 E DIXON BLVD",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281526832",
            "telephone_number": "704-482-4215",
            "fax_number": "704-482-4198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INGLES MARKETS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-03",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A",
        "authorized_official_last_name": "CUCCHI",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "VINCENT",
        "authorized_official_title_or_position": "VP OF PHARMACY",
        "authorized_official_telephone_number": "828-669-2941"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ingles Pharmacy #112",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ingles Pharmacy #112",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shelby, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.