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Export Provider Record NPI 1073940334
Boones Creek Pharmacy, Inc.
Organization Subpart: NO
Active
NPI Number1073940334
NPI TypeNPI-2 Organization
SpecialtyPharmacy, Community/Retail Pharmacy
Provider Details
NPI1073940334
NPI TypeNPI-2 Organization
StatusActive
Enumeration Date2013-10-02
Last Updated2026-04-28
Authorized OfficialCaden Cox
Owner/PIC
Phone: 4232830911
Mailing Address4729 N Roan St Ste 2
Johnson City, TN 37615-3733
United States
Phone: (423) 283-0911 | Fax: (423) 283-0990
📍 View Map
Primary Practice Address4729 N Roan St, Ste 2
Johnson City, TN 37615-3886
United States
Phone: (423) 283-0911 | Fax: (423) 283-0990
📍 View Map
Other Identifiers
IssuerStateNumberOther Issuer
Other (non-Medicare)2142795PK
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
No3336C0004X – Pharmacy, Compounding Pharmacy
No333600000X – Pharmacy
Yes3336C0003X – Pharmacy, Community/Retail PharmacyTN0000002064
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About NPI 1073940334

Boones Creek Pharmacy, Inc. is an organization registered in the CMS NPPES NPI Registry with NPI number 1073940334. The primary specialty listed is Pharmacy, Community/Retail Pharmacy. The organization is located in Johnson City, TN. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2013-10-02. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1073940334?

NPI 1073940334 belongs to Boones Creek Pharmacy, Inc., a Pharmacy, Community/Retail Pharmacy in Johnson City, TN. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.

Is NPI 1073940334 active?

The current status of NPI 1073940334 in the NPPES registry is Active. The record was last updated on 2026-04-28.

What specialty is NPI 1073940334?

NPI 1073940334 is classified under the taxonomy Pharmacy, Community/Retail Pharmacy. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1073940334?

You can verify NPI 1073940334 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1073940334?

The primary practice address on file for NPI 1073940334 is 4729 N Roan St, Johnson City, TN 37615-3886. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1073940334 issued?

NPI 1073940334 was first issued (enumerated) on 2013-10-02. The NPPES record was last updated on 2026-04-28.

Practice Location Map

Boones Creek Pharmacy, Inc. is located at 4729 N Roan St, Johnson City, TN. Use the map below to find directions or verify the practice location.

📍 4729 N Roan St, Johnson City, TN 37615-3886  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Boones Creek Pharmacy, Inc.. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1073940334. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Pharmacy, Community/Retail Pharmacy0000002064TN
Data Verified from CMS NPPES Last synced: 2026-06-20 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162