Organization
CANNONHOMEHEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REGINALD DWIGHT MOORE (CEO)
(704) 200-1832
Entity
Organization
Contact information
Practice address
7108 HOLLYHOUSE DR, 7108 HOLLY HOUSE DR, CHARLOTTE, NC 28215-3734
(704) 200-1832
(704) 454-7464
Mailing address
7108 HOLLYHOUSE DR, CHARLOTTE, NC 28215-3734
(704) 200-1832
(704) 454-7464
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NC
Other
Enumeration date
11/05/2012
Last updated
07/21/2022
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