Organization
STANLEY SPECIALTY PHARMACY, LLC
Active
Other names
Stanley Specialty Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRETT CANNON PHARMD (PIC / OWNER)
(704) 370-6612
Entity
Organization
Contact information
Practice address
3120 LATROBE DR STE 200, CHARLOTTE, NC 28211-2185
(704) 370-6612
(704) 375-5888
Mailing address
3120 LATROBE DR STE 200, CHARLOTTE, NC 28211-2185
(704) 370-6612
(704) 375-5888
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24598
NC STATE PHARMACY LICENSE
NC
Enumeration date
02/24/2023
Last updated
02/24/2023
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