Provider Demographics
NPI:1649330614
Name:COUNTY OF BUNCOMBE
Entity type:Organization
Organization Name:COUNTY OF BUNCOMBE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:GERRALD
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:828-250-5268
Mailing Address - Street 1:35 WOODFIN ST
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-3013
Mailing Address - Country:US
Mailing Address - Phone:828-250-5233
Mailing Address - Fax:828-250-6192
Practice Address - Street 1:40 COXE AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-3308
Practice Address - Country:US
Practice Address - Phone:828-250-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0003X, 3336S0011X
NC039593336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2072465OtherPK
NC0116376Medicaid
4042880001Medicare NSC