Provider Demographics
NPI:1033935531
Name:LUCKY PENNY NC LLC
Entity type:Organization
Organization Name:LUCKY PENNY NC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VANCE
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:KIRKPATRICK
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:828-782-0092
Mailing Address - Street 1:56 FIREFLY RIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:MILLS RIVER
Mailing Address - State:NC
Mailing Address - Zip Code:28759-0102
Mailing Address - Country:US
Mailing Address - Phone:828-230-3715
Mailing Address - Fax:
Practice Address - Street 1:200 SLOPE STREET
Practice Address - Street 2:
Practice Address - City:BRYSON CITY
Practice Address - State:NC
Practice Address - Zip Code:28713
Practice Address - Country:US
Practice Address - Phone:828-782-0092
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-29
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy