Active NPI
Boone Drugs Inc
Doing business as Mountain City Pharmacy
- Pharmacy
- Mountain City, TN
National Provider Identifier
1811022569
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 333600000X
- Legal business name
- BOONE DRUGS INC
- Doing business as
- Mountain City Pharmacy
- Practice address
- 1641 S Shady St
Mountain City, TN 37683-2015 - Phone
- (423) 727-0038
- NPI assigned
- Feb 22, 2007
- Last updated
- Jul 14, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Spencer W Hodges, PHARMD
- Title
- Vice President
- Phone
- (828) 264-3055
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Customized Equipment (DME) | 332BC3200X | |||
| Oxygen Equipment & Supplies (DME) | 332BX2000X | |||
| Pharmacy | 333600000X | 333600000X | TN | Primary |
Addresses
Primary practice location
1641 S Shady St
Mountain City, TN 37683-2015
Mailing address
345 Deerfield Rd
Boone, NC 28607-5009
Phone (828) 355-3365
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0445460 | Medicaid | NC |
Other names 1
- Mountain City Pharmacy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930010100 | TN | DME Supplier - Pharmacy | 8325072655 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Mountain City, TN |
| O20190619003782 | TN | Part B Supplier - Mass Immunization (Roster Biller Only) | 8325072655 | Practice locations: Mountain City, TN |
Other NPIs with the same Medicare PAC ID 6
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba Mountain City Pharmacy & Healthcare
- Durable Medical Equipment & Medical Supplies
- Mountain City, TN
- NPI 1912086182
8325072655
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba Mountain City Pharmacy & Healthcare
- Durable Medical Equipment & Medical Supplies
- Mountain City, TN
- NPI 1912086182
O20100930010100
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
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.
-
- Pharmacist
- Boone, NC
- NPI 1568051969
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172102400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1783987200000",
"number": "1811022569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "345 DEERFIELD RD",
"city": "BOONE",
"state": "NC",
"postal_code": "286075009",
"telephone_number": "828-355-3365",
"fax_number": "828-264-0543"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1641 S SHADY ST",
"city": "MOUNTAIN CITY",
"state": "TN",
"postal_code": "376832015",
"telephone_number": "423-727-0038"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BOONE DRUGS INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-22",
"last_updated": "2026-07-14",
"certification_date": "2026-07-14",
"status": "A",
"authorized_official_last_name": "HODGES",
"authorized_official_first_name": "SPENCER",
"authorized_official_middle_name": "W",
"authorized_official_title_or_position": "VICE PRESIDENT",
"authorized_official_telephone_number": "828-264-3055",
"authorized_official_credential": "PHARMD"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "332BC3200X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
"state": null,
"license": null,
"primary": false
},
{
"code": "332BX2000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "TN",
"license": "333600000X",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0445460",
"state": "NC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Mountain City Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Mountain City, TN
- Blue Ridge Medical Management Corporation (Ballad Health Medical Associates)
- Blue Ridge Medical Management Corporation (MSMG Ortho MTN)
- Blue Ridge Medical Management Corporation (Ballad Health Medical Associates)
- Blue Ridge Senior Living
- Sara Boles, PHARMD
- Boone Drugs Inc (Mountain City Pharmacy & Healthcare)
- Brightside ABA Inc
- Devon Brown, R.N.
- Mica Lauren Brown, FNP
- Alric Wesley Burleson, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; 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.