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Organization
MOORESVILLE PHARMACY EAST LLC
Active
Organization
MOORESVILLE PHARMACY EAST LLC
Active
Other names
Mooresville Compounding Specialties
Organization subpart
No
Provider details
NPI number
Authorized official
GAVIN M HOUCHINS PHARM.D. (OWNER)
(704) 799-6870
Entity
Organization
Contact information
Practice address
439 E STATESVILLE AVE, SUITE A, MOORESVILLE, NC 28115-2533
(877) 454-0448
Mailing address
439 E STATESVILLE AVE, SUITE A, MOORESVILLE, NC 28115-2533
(877) 454-0448
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
08134
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3440093
NABP
NC
Enumeration date
02/22/2007
Last updated
08/22/2020
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