Organization
MOOSE DRUG COMPANY
Active
Other names
Moose Pharmacy of Locust
Organization subpart
No
Provider details
NPI number
Authorized official
RHONDA LYNN DARBY (PHARMACY MANAGER)
(704) 888-2114
Entity
Organization
Contact information
Practice address
1750 MAIN ST W, LOCUST, NC 28097-9793
(704) 888-2114
(704) 888-2125
Mailing address
1750 MAIN ST W, LOCUST, NC 28097-9793
(704) 888-2114
(704) 888-2125
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
07108
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0135822
—
NC
01
—
3435307
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
09/12/2006
Last updated
04/02/2020
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