Organization
MOOSE DRUG COMPANY
Active
Other names
MOOSE COMPOUNDING PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH MOOSE PHARMD (OWNER)
(704) 792-2555
Entity
Organization
Contact information
Practice address
740 CHURCH ST N, CONCORD, NC 28025-4336
(704) 792-2555
(704) 789-9366
Mailing address
740 CHURCH ST N, CONCORD, NC 28025-4336
(704) 792-2555
(704) 789-9366
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
09216
NC
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3405049
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/13/2006
Last updated
04/11/2025
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