Organization
MOORESVILLE PHARMACY EAST, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GAVIN HOUCHINS (OWNER/MANAGER)
(704) 799-6870
Entity
Organization
Contact information
Practice address
439 E STATESVILLE AVE, MOORESVILLE, NC 28115-2533
(704) 799-6870
(704) 799-6871
Mailing address
439 E STATESVILLE AVE, MOORESVILLE, NC 28115-2533
(704) 799-6870
(704) 799-6871
Taxonomy
Speciality
Code
Description
License number
State
3336S0011X
Specialty Pharmacy
Primary
07707
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0497129
—
NC
Enumeration date
11/09/2011
Last updated
11/09/2011
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