Organization
HEALTHSMART PHARMACY LLC
Active
Other names
HEALTHSMART PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DOUG BALOG (MANAGER)
(704) 906-0281
Entity
Organization
Contact information
Practice address
108 LEANING OAK DR, MOORESVILLE, NC 28117
(704) 658-1184
(794) 658-1184
Mailing address
108 LEANING OAK DR, MOORESVILLE, NC 28117
(704) 658-1184
(794) 658-1184
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
10131
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0497682
—
NC
01
—
3411458
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/17/2008
Last updated
12/02/2009
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