Organization
MOOSE PHARMACY OF MONROE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES M BOWMAN PHARMD (MANAGER/MEMBER)
(704) 918-0867
Entity
Organization
Contact information
Practice address
215 E JEFFERSON ST, MONROE, NC 28112-4865
(704) 283-8131
(704) 289-1954
Mailing address
215 E JEFFERSON ST, MONROE, NC 28112-4865
(704) 283-8131
(704) 289-1954
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14278
NORTH CAROLINA BOARD OF PHARMACY LICENSE NUMBER
NC
Enumeration date
01/29/2020
Last updated
03/07/2023
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