Organization
MOOSE PHARMACY OF KANNAPOLIS INC
Active
Other names
Moose Pharmacy of Kannapolis
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE YODER (TREASURER)
(704) 636-6340
Entity
Organization
Contact information
Practice address
1113 N MAIN ST, KANNAPOLIS, NC 28081-2256
(704) 932-9111
(704) 932-0197
Mailing address
1113 N MAIN ST, KANNAPOLIS, NC 28081-2256
(704) 932-9111
(704) 932-0197
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
10588
NC
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0805839
—
NC
01
—
2126869
PK
—
Enumeration date
01/31/2007
Last updated
04/21/2023
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