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BOONES CREEK PHARMACY, INC.
NPI 1073940334
Pharmacy - Community/Retail Pharmacy in Johnson City, TN

Active since October 02, 2013CLIA 44D2189630 · Waiver
4729 N ROAN ST, STE 2, JOHNSON CITY, TN 37615(423) 283-0911(423) 283-0990 Get Directions Write a Review

NPPES record last updated: April 28, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 28, 2026, Apr 7, 2023, Jan 14, 2021 and 1 more (4 updates tracked since 2017).

About Boones Creek Pharmacy, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BOONES CREEK PHARMACY, INC. (NPI 1073940334), doing business as Boones Creek Pharmacy, is a healthcare organization registered as a community/retail pharmacy in Johnson City, Tennessee and active in the NPI registry since October 2013. The organization holds a CLIA Waiver certificate valid through August 3, 2026 and lists Caden Cox, Owner/pic, as its authorized official.

NPPES Registry Identity

NPI1073940334
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameBOONES CREEK PHARMACY, INC.
Location Address4729 N ROAN ST, STE 2Johnson City, TN 37615-3886
Mailing Address4729 N Roan St Ste 2Johnson City, TN 37615-3733 · (423) 283-0911 · Fax (423) 283-0990
Phone(423) 283-0911
Fax(423) 283-0990
Organization SubpartNo
Authorized OfficialCaden CoxOwner/pic · (423) 283-0911
Enumeration DateOctober 2, 2013
Last NPPES UpdateApril 28, 20264 updates tracked since enumeration
NPPES CertifiedApril 28, 2026
✔ NPI 1073940334 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in TN · 0000002064
Definition
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Also ListedPharmacyTaxonomy 333600000X
Also ListedPharmacy · Compounding PharmacyTaxonomy 3336C0004X
4729 N ROAN ST, Johnson City, TN 37615
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Other Names 1

Doing Business AsBoones Creek Pharmacy

Other Identifiers 1

Other2142795Pk

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 44D2189630

Boones Creek Pharmacy · Johnson City, TN
Active · expires Aug 3, 2026
CLIA Number44D2189630
Laboratory TypePharmacy
Certificate Effective DateAugust 4, 2024
Certificate Expiration DateAugust 3, 2026
Laboratory DirectorCaden Cox
Laboratory Phone(423) 283-0911
Laboratory LocationBoones Creek Pharmacy4729 N Road St, #2, Johnson City, TN 37615
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
81 services80 patients
Influenza vaccine, inactivated 90653
The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.
79 services79 patients
Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677
The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.
18 services18 patients
Administration of pneumococcal vaccine G0009
The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.
18 services18 patients

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

THOMAS P ROWAN DPH
Pharmacist
4729 N ROAN ST, SUITE 2
JOHNSON CITY, TN 37615
Washington County (423) 283-0911
ROWAN ENTERPRISES INC
Pharmacy (Community/Retail Pharmacy)
4729 N ROAN ST, STE 2
JOHNSON CITY, TN 37615
Washington County (423) 283-0911
MARK GUIMOND PHARMD
Pharmacist
4729 N ROAN ST, SUITE 2
JOHNSON CITY, TN 37615
Washington County (423) 283-0911

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Boones Creek Pharmacy, Inc.'s NPI number?

The NPI number for Boones Creek Pharmacy, Inc. is 1073940334. It was assigned to this organization in the NPPES registry on October 2, 2013. The provider is doing business as Boones Creek Pharmacy.

Where is Boones Creek Pharmacy, Inc. located?

Boones Creek Pharmacy, Inc. is located at 4729 N Roan St Ste 2, Johnson City, TN 37615. The listed phone number is (423) 283-0911.

What is Boones Creek Pharmacy, Inc.'s specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Does Boones Creek Pharmacy, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 44D2189630) is associated with this NPI, valid through August 3, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Boones Creek Pharmacy, Inc. accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 51 other insurers list Boones Creek Pharmacy, Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Boones Creek Pharmacy, Inc. was last updated on April 28, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.