Organization
MOORESVILLE PHARMACY, LLC
Active
Other names
HealthSmart Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS A BALOG (OWNER/MANAGER)
(704) 658-1184
Entity
Organization
Contact information
Practice address
108 LEANING OAK DR, MOORESVILLE, NC 28117-6991
(704) 658-1184
(704) 658-1184
Mailing address
108 LEANING OAK DR, MOORESVILLE, NC 28117-6991
(704) 658-1184
(704) 658-1184
Taxonomy
Speciality
Code
Description
License number
State
3336S0011X
Specialty Pharmacy
Primary
7780
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0497153
—
NC
Enumeration date
03/31/2011
Last updated
03/31/2011
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