Organization
MOOSE DRUG COMPANY
Active
Other names
MOOSE DRUG COMPANY
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM MOOSE JR. RPH (OWNER PHARMACY MANAGER)
(704) 436-9613
Entity
Organization
Contact information
Practice address
8374 W FRANKLIN ST, MT PLEASANT, NC 28124-8812
(704) 436-9613
(704) 436-6512
Mailing address
PO BOX 67, MT PLEASANT, NC 28124-0067
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
05395
NC
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0135046
—
NC
01
—
3409237
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/30/2006
Last updated
08/31/2020
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